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Assessment of Failed Arthroscopic Anterior Labral Repairs

Findings at Open Surgery

Naval Medical Center, San Diego, California

Mark T. McBride, LCDR, MC, USNR

Naval Medical Center, San Diego, California

John M. Lapoint, CAPT, MC, USN

Naval Medical Center, San Diego, California

To assess capsulolabral lesions present in patients after unsuccessful arthroscopic procedures, we re viewed the records of 20 patients who had undergone open shoulder procedures after unsuccessful arthro scopic Bankart procedures for chronic shoulder insta bility. The Bankart lesion had initially been repaired arthroscopically by transglenoid sutures (N = 10), bio absorbable tacks (N = 7), suture anchors (N = 2), or arthroscopic screws (N = 1). Five of the 20 patients (25%) had reinjuries to the shoulder after the arthro scopic procedure. The average time from the arthro scopic to the open procedure was 17.9 months. Over all, 12 of the 20 patients (60%) had healed Bankart lesions at the time of open surgery. Eight of the 20 patients (40%) were found to have persistent Bankart lesions, and 15 of the 20 patients (75%) were found to have redundant anterior capsules. The presence of a persistent Bankart lesion significantly correlated with postarthroscopic dislocation, and the presence of cap sular laxity significantly correlated with postarthro scopic subluxation. We concluded that capsular laxity is difficult to quantify arthroscopically and is present in a significant percentage of patients with chronic trau matic shoulder instability. Failure to successfully treat either the Bankart lesion or capsular laxity at the time of an arthroscopic Bankart procedure may lead to post operative instability.

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