Scapular bone grafting with allograft pin fixation for repair of bony Bankart lesions: A biomechanical study

BACKGROUND Severe bony Bankart lesions are a difficult challenge in clinical treatment and research.The current treatment methods consist mostly of Latarjet-Bristow surgery and its modified procedures.While good results have been achieved,there are also complications such as coracoid fracture,bone graft displacement,and vascular and nerve injury.AIM To analyze the techniques and biomechanical properties of transversely fixing a bone block from the scapular spine using bone allograft pins with suture threads to repair bony Bankart lesions.METHODS Fresh human shoulder joint specimens and a cadaver specimen model for scapular bone grafting with allograft pin fixation for repair of bony Bankart lesions were used.When the humeral rotation angles were 0°,30°,60°and 90°,and the axial loads were 30 N,40 N,and 50 N,the humerus displacement was studied by biomechanical experiments.RESULTS When the angle of external rotation of the humerus was 0°,30°,60°,and 90°,with axial loads of 30 N,40 N,and 50 N,the data of the normal control group,allograft pin repair group,and titanium alloy hollow screw repair group were compared with each other by the q-test,which showed that there were no statistically differences among the three groups(P>0.05).CONCLUSION The joints repaired with bone block from the scapular spine transversely fixed with allograft bony pins to repair bony Bankart lesions show good mechanical stability.The bone block has similar properties to normal glenohumeral joints in terms of biomechanical stability.

Similar functional outcome using single anterior portal and standard two portals technique in recurrent dislocation of shoulder

Purpose:Recurrent dislocation of shoulder(RDS)is a common injury in high demand professionals,like athletes and military personnel.The treatment for the patients with Bankart lesion is the arthroscopic repair.This present study compares the outcomes of two different techniques of arthroscopic Bankart repair i.e.a standard two anterior portals technique and a single anterior portal technique in patients with RDS.Methods:Patients with traumatic RDS met the inclusion criteria were managed with Bankart repair using either two anterior portals(Group A)or a single anterior portal(Group B)technique.Patients were evaluated before the intervention and at the mean follow-up of approximately two years using Rowe score,Oxford shoulder score and Tegner activity scale.Results:The mean age of the patients in Groups A(n=34)and B(n=37)was 29.64 years and 29.05 years respectively(p=0.66).The dominant shoulder was involved in 27 patients in Group A and 22 patients in Group B(p=0.069).The operative time in Group A and B was 68.52 min and 46.35 min,respectively(p<0.001).The complications at follow-up,the mean Rowe score and Oxford score improved significantly in both groups compared with the pre-operative values.However,the final outcome scores were not significantly different between the both groups.The median Tegner's score preoperatively and at follow-up was 7 and 6,respectively in Groups A and B.Conclusions:Single anterior portal technique is an effective treatment modality,yielding a similar outcome as two anterior portals technique in the management of RDS.