Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations

Aydın, Nuri; Ünal, Mehmet; Aşansu, Mustafa Akif; Tok, Okan

doi:10.1177/2309499017718952

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…In only 7 of 51 studies with potential eligibility were clinical outcomes adequately quantified. These 7 studies, 3,10,14,17,19,25,60 consisting of 520 patients, were included in the final analysis.…”

Section: Resultsmentioning

confidence: 99%

Outcomes for Arthroscopic Repair of Combined Bankart/SLAP Lesions in the Treatment of Anterior Shoulder Instability: A Systematic Review and Meta-analysis

Feng

Song

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Arthroscopic repair of combined Bankart/superior labral anteroposterior (SLAP) lesions is commonly performed to treat anterior shoulder instability, the clinical outcomes of which have not been widely studied.Purpose:To compare the clinical outcomes for arthroscopic repair of combined Bankart/SLAP lesions in the treatment of anterior shoulder instability and to ascertain whether it is inferior to isolated Bankart repair.Study Design:Systematic review; Level of evidence, 3.Methods:A systematic review of the literature was performed through use of the MEDLINE, EMBASE, and Cochrane Library databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study bias was assessed using the MINORS (Methodological Index for Non-Randomized Studies) scoring system. Randomized controlled trials, prospective or retrospective cohort studies, and case-control studies were included, whereas systematic reviews, literature reviews, conference abstracts, case reports, case series, and non-peer-reviewed studies were excluded to guarantee the quality of the study. Data on outcomes including recurrence rate, functional scores, and range of motion (ROM) were pooled, with statistical analysis performed. A P value of <.05 was considered statistically significant.Results:The review included 7 studies with a total of 520 patients. The pooled recurrence rate after combined Bankart/SLAP repair was 6.47% (9/139). Significant improvements of postoperative versus preoperative functional scores were observed, including a reduction in the visual analog scale score for pain (mean ± SD: 0.99 ± 1.36 vs 4.13 ± 2.26; P < .00001) and an increase in mean Rowe score (89.56 ± 11.46 vs 43.16 ± 8.87; P < .00001) and mean Constant score (91.41 ± 7.57 vs 59.70 ± 5.63; P < .00001). In terms of ROM, no reduction was found in external rotation (66.56° ± 13.33° vs 67.22° ± 14.27°; P = .21), and a significant increase in abduction was found (157.67° ± 4.11° vs 144.18° ± 8.28°; P < .00001). No statistically significant difference was found between arthroscopic repair of combined Bankart/SLAP lesions and isolated Bankart repair regarding recurrence rate, functional scores, or ROM.Conclusion:Of the pooled data, patients who underwent arthroscopic repair of combined Bankart/SLAP lesions in treatment of anterior shoulder instability showed a low recurrence rate, favorable functional scores, and no significant restriction on ROM, all of which were not significantly worse than outcomes of isolated Bankart repair. Therefore, combined repair was proven to be a viable option for extensive labral lesions.

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Section: Resultsmentioning

confidence: 99%

Outcomes for Arthroscopic Repair of Combined Bankart/SLAP Lesions in the Treatment of Anterior Shoulder Instability: A Systematic Review and Meta-analysis

Feng

Song

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…[26,27] In similar studies that have compared isolated Bankart and accompanying SLAP lesions, recurrence rates of 4.2% and 8.7% have been reported. [19,20] In our study, this rate was 7.3%. There are many factors that increase the risk of recurrence after anterior instability surgery and cause unsuccessful results.…”

Section: Discussionmentioning

confidence: 42%

“…[16] The authors suggested that the bowstring effect of the labrum contributes to the maintenance of tension and anatomical reduction of the anteroinferior labrum. Aydin et al [20] advocated that repair of the anteroinferior labral lesion should occur first to perform the best reduction of the labral tears. Some studies have claimed that if the SLAP repair is performed first, it can be difficult to clearly visualize the anterior labrum, and that the "pseudolaxity" provided by the SLAP lesion improves the visibility and working space during anterior labral repair.…”

Section: Discussionmentioning

confidence: 99%

“…This rate is about 11 to 27% in the literature. [ 2 , 6 , 16 - 18 ] Type V SLAP lesions were detected in 36.6% of cases in Durban et al,[ 19 ] 40% in Gül et al,[ 17 ] and 34% in Aydin et al[ 20 ] studies. In our case series, it was approximately 39%, which is in accordance with the literature.…”

Section: Discussionmentioning

confidence: 99%

“…A limited number of studies have compared the clinical results of isolated Bankart and type V SLAP lesions, and a variety of shoulder scoring systems have been used to evaluate clinical outcomes. Aydin et al[ 20 ] used the Constant and Rowe scoring systems, Durban et al[ 19 ] used the Rowe scoring system, Cho et al[ 16 ] used the American Shoulder and Elbow Surgeon and Rowe scoring systems, and Hantes et al[ 18 ] used the Constant and Rowe scoring systems. None of these studies found a significant difference between the two groups in terms of clinical scoring systems.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the clinical results of isolated Bankart and SLAP 5 lesions after arthroscopic repair

et al. 2020

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The glenohumeral joint is the most mobile joint in the human body. Shoulder stability is provided by static and dynamic stabilizers and load resistance is ensured by these stabilizers. [1] Damage to these structures leads to dislocation and recurrent instability. Traumatic anterior instability or dislocation of the shoulder joint usually results in avulsion of the anterior inferior labrum. Bankart defined this lesion as the "essential lesion" of shoulder instability. [2] In addition to Bankart lesions, lesions in different areas of the labrum can occur, such as superior labrum anterior to posterior (SLAP) lesions. Superior labral tears were first defined by Andrews et al. in 1985. [2] Then in 1990, Snyder [3] coined the term SLAP lesions. With SLAP lesions, the superior labrum detaches along with the biceps tendon and the labral tear extends anteriorly from the posterior superior labrum. Snyder further classified SLAP lesions into four categories and over time different types of SLAP lesions were added to Snyder's classification. [3-5] The etiology of SLAP lesions remains uncertain. There Objectives: This study aims to compare the clinical results of patients with traumatic isolated Bankart lesions and type V superior labrum anterior to posterior (SLAP) lesions after arthroscopic repair. Patients and methods: Patients who underwent arthroscopic repair for traumatic anterior glenohumeral instability were evaluated retrospectively between December 2014 and January 2019. Fifty-one patients (49 males, 2 females; mean age 25 years; range, 18 to 36 years) without bone defects affecting >20% of the glenoid fossa, off-track engaging Hills-Sachs lesions, multidirectional instability, or ligamentous laxity were included in the study. Group 1 had 31 patients with isolated Bankart lesions and group 2 had 20 patients with type V SLAP lesions. There were only two female patients in group 1 and all patients were male in group 2. The mean age was 25 years (range, 18 to 36 years) in group 1 and 25 years (range, 19 to 35 years) in group 2. Rowe, Constant, and Western Ontario Shoulder Instability (WOSI) scoring systems were used to evaluate the clinical outcomes of the patients preoperatively and at the last follow-up. Results: The mean follow-up time was 32 months (range, 12 to 48 months) in group 1 and 28.5 months (range, 12 to 42 months) in group 2. There were no statistically significant differences between the two groups in terms of the number of shoulder dislocations before the surgery, mean age at the time of surgery, and the mean time from the first dislocation to surgical treatment. When the Rowe, Constant, and WOSI scores were evaluated preoperatively and at the last follow-up, there were statistically significant changes within, but not between, the two groups. Conclusion: In type V SLAP lesions, the affected and repaired labrum surface area is larger than isolated Bankart lesions. However, as a result of appropriate surgical treatment, the affected surface area does not have a negative effect on clinical outcomes, and s...

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Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up

Desai

Mangold

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To compare rates of recurrent instability, revision surgery and functional outcomes following arthroscopic anterior capsulolabral repair for recurrent anterior instability using knot-tying versus knotless suture anchor techniques. Methods Patients who had undergone arthroscopic anterior labrum and capsular repair for recurrent anterior glenohumeral instability using knotless anchors were identiied. Those with minimum 2-year follow-up were matched (1:2) to knot-tying anchor repair patients. Rates of failure and recurrent instability were compared, as well as Visual Analog Scale (VAS), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), University of California Los Angeles (UCLA) and Rowe scores. Results One hundred and two patients (89 males, 13 females) with a mean age of 24.3 ± 9.6 were included. Repair was performed with knotless anchors in 34 and knot-tying anchors in 68 shoulders. At mean follow-up of 4.8 ± 2.5 years, redislocation rates between groups were not signiicantly diferent (knotless anchor: 9% versus knot-tying group: 15%, n.s.), but the knot-tying group showed a higher re-subluxation rate (p = 0.039). 12 (18%) revisions were performed in the knottying group at a mean 2.9 years after surgery and 1 (3%) revision in the knotless anchors group at 1.4 years (n.s.). There was no diference in mean VAS with use (1.3 ± 1.9 versus 0.8 ± 1.

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Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations

Cited by 19 publications

References 25 publications

Outcomes for Arthroscopic Repair of Combined Bankart/SLAP Lesions in the Treatment of Anterior Shoulder Instability: A Systematic Review and Meta-analysis

Outcomes for Arthroscopic Repair of Combined Bankart/SLAP Lesions in the Treatment of Anterior Shoulder Instability: A Systematic Review and Meta-analysis

Comparison of the clinical results of isolated Bankart and SLAP 5 lesions after arthroscopic repair

Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up

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