Arthroscopic Bankart Repair With and Without Curettage of the Glenoid Edge: A Prospective,Randomized, Controlled Study |
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| Institution: | 1. Department of Orthopaedics, Augusta University Medical Center, Augusta, Georgia, U.S.A.;2. Medical College of Georgia, Augusta University, Augusta, Georgia, U.S.A.;3. Steadman Philippon Research Institute, Vail, Colorado, U.S.A.;1. Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;2. Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;1. Department of Orthopaedic Surgery, University of California San Diego, San Diego, California, U.S.A.;2. Rady Children’s Hospital and Health Center, San Diego, California, U.S.A.;1. Sports Medicine Center, San Giovanni-Addolorata Hospital, Rome, Italy;2. Orthopaedic and Traumatology Unit, Pellegrini Hospital, Naples, Italy;3. BG Trauma Center, Department of Traumatology, Eberhard Karls University, Tübingen, Germany;4. Arthroscopy Unit, Carlo Poma Hospital, Mantua, Italy;5. Isokinetic Group, Rome, Italy;1. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.;2. Department of Orthopaedic Surgery, University of Iowa, Iowa City, Iowa, U.S.A.;3. Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A. |
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| Abstract: | PurposeTo determine whether curettage of the cartilage on the glenoid edge in arthroscopic Bankart repair reduces the postoperative recurrence rate compared with noncuretted glenoid.MethodsBetween January 2010 and December 2013, 134 patients underwent arthroscopy and stabilization for recurrent anterior dislocation of shoulder; 42 patients were excluded. Alternate glenoid edge was curetted in 92 patients undergoing arthroscopic Bankart repair. Twelve patients were lost to follow-up. The remaining 80 patients were divided into 2 groups of 40 patients each, curettage and noncurettage. In both groups, the Bankart lesion was repaired using ≥3 bioanchors loaded with nonabsorbable braided sutures. Postoperative rehabilitation was the same for the 2 groups. We recorded recurrence of instability, pain, and Constant and Rowe shoulder scores. Statistical analysis of data was performed using unpaired t test (significance level P < .05).ResultsThe 2 groups were comparable in terms of age, number of dislocations, and bone loss. The average follow-up was 7 years and 9 months (range 6 to 10 years). Of the total 40 patients in the curettage group, 6 (15%) had recurrence of dislocation and none had subluxations, whereas in the noncurettage group, 13 (32.5%) had recurrence of dislocation and 3 (7.5%) had subluxations. The difference in postoperative recurrence of instability was statistically significant (P = .012). The average (standard deviation) Rowe score was 83.75 (23.28) in the curettage group and 70.13 (31.29) in the noncurettage group (P = .030).ConclusionsDuring arthroscopic Bankart repair, curettage of the cartilage on the anterior glenoid edge reduces the incidence of postoperative recurrence of instability.Level of EvidenceII, therapeutic; prospective, randomized, controlled study. |
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