Arthroscopic approach to acute bony Bankart lesion

PURPOSE: To report on an arthroscopic approach to a bony Bankart lesion that uses a modified Bankart technique to fix the avulsed bone fragment to the healthy glenoid. TYPE OF STUDY: Case series study. METHODS: Of 250 patients who received surgical treatment for shoulder dislocation at our unit, 25 sport-practicing patients with acute traumatic dislocation of the shoulder and anterior glenoid rim fracture were included in this study. Inclusion criteria were bony Bankart lesions less than 3 months old and involving less than 25% of the glenoid, absence of associated lesions, and follow-up longer than 2 years. Arthroscopic procedures were performed using a modified Bankart technique to fix the avulsed bone fragment to the healthy glenoid rim using suture anchors. A modified Rowe score was devised for evaluating range of motion outcomes. RESULTS: Shoulder function and stability were restored in 23 patients (92%) by 2 years after surgery. There was no recurrence of instability. Range of motion was minimally reduced. All patients resumed sports activities: 23 (92%) at the same level of performance as before surgery and 2 (8%) at a lower level because of 20 degrees loss of external rotation. CONCLUSIONS: This arthroscopic technique seems to offer an optimal method for evaluating and treating isolated acute bony Bankart lesions involving less than 25% of the glenoid.