Glenoid Radius of Curvature and Humeral Head Volume Are Associated With Postoperative Dislocation After Arthroscopic Bankart Repair

Abstract

Purpose: To measure bony morphologic parameters and identify their association with arthroscopic Bankart repair failure. Methods: This was a retrospective comparative study. The inclusion criteria were primary arthroscopic Bankart repair, no prior shoulder surgery, traumatic cause, and had a Bankart (soft tissue and bony) lesion evident on magnetic resonance imaging (MRI). The exclusion criteria were posterior labral pathology, multidirectional instability, connective tissue disorder, rotator cuff pathology, and those who underwent concomitant shoulder procedures. Patients who had a postoperative redislocation (unstable group) were compared with matched patients who did not (stable group). Data were obtained by chart review and from preoperative MRI. Comparisons were made using the Student t test, Fisher exact test, or χ2 test. Statistical significance was defined as P < .05. Inter-rater reliability was measured between reviewers. Results: A total of 45 patients experienced a postoperative dislocation and were matched to 90 patients without a postoperative dislocation. There were no differences in demographic and radiographic variables. The radius of curvature (ROC) of the glenoid was larger (shallower) in the unstable group (23.6 mm vs 22.6 mm, P = .05). The humeral head volume (HHV) trended higher in the unstable group (68.9 mL vs 62.9 mL, P = .06). The glenoid volume was not significantly different. A greater percentage of patients with a glenoid ROC of 24.5 mm or greater (62.1% vs 26.4%, P = .0003) and an HHV of 80 mm3 or greater (60.8% vs 28.9%, P = .003) experienced a redislocation compared with patients without these factors. Patients with a glenoid ROC of 24.5 mm or more and an HHV of 80 mm3 or more had greater than 4 times the odds of redislocation (odds ratio, 4.56; 95% confidence interval, 1.44-14.43; P = .0098). Strong inter-rater reliability was found for the HHV, glenoid volume, glenoid ROC, and humeral head ROC measurements (r = 0.94, r = 0.88, r = 0.89, and r = 0.95, respectively). Conclusions: This study shows that large ROC (shallow) glenoids in conjunction with large humeral heads may predispose patients to failure after arthroscopic Bankart repair. Level of Evidence: Level III, retrospective comparative trial.