Anchor placement to glenoid rim during Bankart repair recreates contact area of anterior capsulolabral complex on glenoi
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ORIGINAL ARTICLE
Anchor placement to glenoid rim during Bankart repair recreates contact area of anterior capsulolabral complex on glenoid better than onto articular surface Yoshiaki Itoigawa1,2 · John W. Sperling3 · Scott P. Steinmann3 · Eiji Itoi 4 · Kai‑Nan An 1 Received: 30 November 2019 / Accepted: 6 May 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose This study aimed to compare the contact areas of Bankart repair with suture anchors placed on the articular surface of the glenoid versus at the rim of the glenoid because it is unclear which technique most effectively restores the footprint after Bankart repair. Methods Ten fresh frozen cadaveric shoulders (mean age 70.7 years) were dissected. The attachment site of the capsulolabral complex from the 1 o’ clock position to the 6 o’clock position was marked with ink, and the contact area of the anteriorinferior capsulolabral complex on the glenoid neck was measured using imageJ. Bankart lesions were created, and two types of Bankart repair were performed on each specimen. The suture anchors were inserted at the glenoid rim (Rim group) and onto the glenoid articular surface 2 mm from the rim (Surface group). Using pressure-sensitive films, we examined the interface contact area. Results The Rim group recreated 64.9% of the native surface area, while the Surface group recreated 47.3% of the area. The Rim group recreated significantly greater contact area compared to the Surface group (P = 0.0008). Conclusion The anchor placement to the glenoid rim recreates the footprint of the capsulolabral complex on the anterior inferior glenoid better than the anchor placement onto the articular surface. Keywords Shoulder · Glenoid labrum · Instability · Biomechanics · Bankart repair
Introduction
Disclaimer All authors (Yoshiaki Itoigawa, John W. Sperling, Scott P. Steinmann, Eiji Itoi, and Kai-Nan An), their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. * Yoshiaki Itoigawa [email protected] 1
Biomechanics Laboratory and Tendon and Soft Tissue Biology Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, USA
2
Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2‑1‑1 Tomioka, Urayasu, Chiba 279‑0021, Japan
3
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
4
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
Arthroscopic reattachment of the AnteroInferior Glenohumeral Ligament-Labrum complex (AIGHL-LC) to the anterior glenoid rim with suture anchors is a standard procedure for the treatment of recurrent anterior shoulder dislocation [1–3]. For surgical stabilization, many authors have advocated specific surgical techniques, such as repair of the labrum onto the glenoid articular surface [4–7] a few millimeters from the edge (Surface) or at the articular rim (Rim) [8
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