Bankart repair alone in combined Bankart and superior labral anterior-posterior lesions preserves range of motion without compromising joint stability

Abstract

Hypothesis: The purpose was to investigate joint stability and range of motion after a Bankart repair without superior labral anterior-posterior (SLAP) repair (termed “Bankart repair”) and after combined Bankart and SLAP repairs (termed “combined repair”). Methods: Eight fresh-frozen shoulders were used. Combined Bankart and SLAP lesions were created (10- to 6-o'clock positions). The labrum and capsule were repaired at the 2-o'clock, 3:30 clock-face, and 5-o'clock positions in the Bankart repair group and at the 11-o'clock, 1-o'clock, 2-o'clock, 3:30 clock-face, and 5-o'clock positions in the combined repair group. The internal- and external-rotation ranges of motion were determined with the arm positioned at 0° and 60° of glenohumeral abduction. The rotation angle was defined when a constant torque of 200 N-mm was applied. Joint stability was measured with a custom stability-testing device. The peak translational force in the anterior-posterior direction was measured with the arm at the end range of external rotation. Results: External rotation angles were greater at 0° and 60° of abduction in the Bankart repair group than in the combined repair group (0° of abduction, P < .01; 60° of abduction, P < .05). The internal rotation angle was greater at 60° of abduction in the Bankart repair group than in the combined repair group (P < .01). The stability between the 2 groups was not significantly different (P = .60). Conclusion: In patients with combined Bankart and SLAP lesions and the need for a wide range of motion, a Bankart repair alone may provide a greater range of motion without compromising the joint stability at the end range compared with a combined repair.

Keywords

• Shoulder
• glenoid labrum
• instability
• biomechanics
• Bankart repair
• SLAP repair