Comparison of anterior single- and standard two-portal techniques in arthroscopic Bankart repair

Abstract

Objectives: This study aims to compare the outcomes of patients undergoing a single anterior portal or a standard two-portal arthroscopic procedure for Bankart repair. Patients and methods: Between January 2015 and March 2018, a total of 71 consecutive patients (53 males and 18 females; mean age: 33.3±10.3 years; range, 17 to 56 years) who underwent arthroscopic Bankart repair with a minimum two-year follow-up period were included. The patients were divided into two groups according to the arthroscopic technique used: single anterior portal group (Group 1, n=32) and standard two-portal group (Group 2, n=39). Demographic and surgical characteristics of the patients were recorded. Pre- and postoperative clinical and functional outcomes were evaluated using the external rotation degree, as well as Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles (UCLA) Shoulder Rating Scale, Constant-Murley Score (CMS), Oxford Shoulder Instability Score (OSIS), and Rowe scores. The clinical and functional outcomes and revision rates were compared between the groups. Results: The mean follow-up was 32.0±7.4 months in Group 1 and 38.0±13.4 months in Group 2 (p=0.222). Good-to-excellent postoperative functional and clinical outcomes were achieved in both groups at the final follow-up, compared to baseline (p<0.001 for all). No significant difference was observed in the postoperative outcomes including daily sports activity, VAS, ASES, UCLA Shoulder Rating Scale, CMS, OSIS, and Rowe scores, and external rotation restriction degrees between the groups (p=0.270, p=0.190, p=0.313, p=0.248, p=0.125, p=0.203, p=0.318, p=0.083, respectively). The operative time in Group 1 was significantly lower than that in Group 2 (60.3±8.3 vs. 71.4±7.2, respectively; p=0.001). Four patients (5.6%) experienced recurrent dislocation with no significant difference between the groups (p=0.622). No significant complications occurred in the peri- or postoperative period. Fifty-eight (81.7%) patients returned to their preoperative sports activity level. The mean time to return to sports was 7.2±1.7 months. Conclusion: Good-to-excellent clinical and functional outcomes can be obtained after arthroscopic Bankart repair, regardless of the use of a single or two anterior working portals. However, the single-portal technique is associated with reduced the operative time, compared to two-portal technique.

Single Working Portal Technique with 70-Degree Arthroscope for Arthroscopic Bankart Repair

“…There are many articles that describe the use of a single-working portal for shoulder arthroscopy. 10 , 11 , 12 , 13 , 14 In this article, we describe a surgical technique that minimizes portal-related complications by using a single working portal and one viewing portal.…”

Results of Arthroscopic Treatment for Anteroinferior Shoulder Instability Using a Single Anterior Working Portal Using Birdbeak

“…In recent studies, tests such as Constant Shoulder Score, RWS and OSIS were evaluated in the anterior single portal group, and no statistical difference was found in the postoperative test scores between the two groups. (7,12,13).…”

Results of arthroscopic treatment for anteroinferior shoulder instability using a single anterior working portal using birdbeak

“…There are a limited number of studies in the literature comparing anterior single portal and anterior double portal techniques. In recent studies, tests such as Constant Shoulder Score, RWS and OSIS were evaluated in the anterior single portal group, and no statistical difference was found in the postoperative test scores between the two groups [ 11 , 18 , 19 ].…”