Skip to main content
SpringerLink
Log in

Arthroscopic Bankart repair with all-suture anchors does not cause important glenoid bone osteolysis: a volumetric CT study of 143 anchors

  • SHOULDER
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate with computed tomography (CT) the incidence of anchor-related osteolysis after implantation of two types of all-suture anchors for the management of labral lesions in shoulder instability.

Methods

Single-cohort, observational study with 12-month follow-up. Thirty-three participants (27 males/6 females; age 38.3 years [SD 11.3]) with anterior labral lesions in which 143 all-suture anchors (71 Iconix 1.4 mm and 72 Suturefix 1.7 mm) were implanted were evaluated with a CT performed a mean of 15.4 [3.85] months after surgery. The volume of the bone defects was measured in the CT. Every anchor was classified into one of four groups: (1) no bone defect. (2) Partial bone defect (defects smaller than the drill used for anchor placement). (3) Tunnel enlargement (defects larger than the drill volume but smaller than twice that volume). (4) Cystic lesion (defects larger than twice the drill volume).

Results

No bone defect was identified in 16 anchors (11.2%, [95% CI 6.5–17.5%]). A partial bone defect was found in 84 anchors (58.7% [50.2–66.9%]). Tunnel enlargement was found in 43 anchors (30.11% [22.6–37.6%]). No anchor caused cystic lesions (0% [0–2.5%]). The defect volume was a mean of 27.8 mm3 (SD 18.4 mm3, minimum 0 mm3, maximum 94 mm3). Neither the position in the glenoid nor the type of implant used had a significant effect in the type or size of the defects.

Conclusion

When using all-suture anchors in the glenoid during instability surgery, relevant bone osteolytic defects are rare at 1-year follow-up. Most anchor insertion tunnels will fill completely (11%) or partially (59%) with bone. Tunnel enlargement will develop in 30% of anchors. No cystic defects larger than 0.125 cm3 were observed. There is a low risk that all-suture anchors cause significant osteolytic bone defects in the glenoid. These implants can be used safely.

Level of evidence IV

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Augusti CA, Paladini P, Campi F, Merolla G, Bigoni M, Porcellini G (2015) Anterior glenoid rim fracture following use of resorbable devices for glenohumeral stabilization. Orthop J Sports Med 3:2325967115586559

    Article  Google Scholar 

  2. Bankart AS (1923) Recurrent or habitual dislocation of the shoulder-joint. Br Med J 2:1132–1133

    Article  CAS  Google Scholar 

  3. Barber FA, Herbert MA (2017) All-suture anchors: biomechanical analysis of pullout strength, displacement, and failure mode. Arthroscopy 33:1113–1121

    Article  Google Scholar 

  4. Boileau P, Villalba M, Hery JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Jt Surg Am 88:1755–1763

    Article  Google Scholar 

  5. Cameron KL, Mauntel TC, Owens BD (2017) The epidemiology of glenohumeral joint instability: incidence, burden, and long-term consequences. Sports Med Arthrosc Rev 25:144–149

    Article  Google Scholar 

  6. Dhawan A, Ghodadra N, Karas V, Salata MJ, Cole BJ (2012) Complications of bioabsorbable suture anchors in the shoulder. Am J Sports Med 40:1424–1430

    Article  Google Scholar 

  7. Di Giacomo G, Itoi E, Burkhart SS (2014) Evolving concept of bipolar bone loss and the Hill–Sachs lesion: from "engaging/non-engaging" lesion to "on-track/off-track" lesion. Arthroscopy 30:90–98

    Article  Google Scholar 

  8. Gao B, DeFroda S, Bokshan S, Ready LV, Sullivan K, Etzel C et al (2020) Arthroscopic versus open Bankart repairs in recurrent anterior shoulder instability: a systematic review of the association between publication date and postoperative recurrent instability in systematic reviews. Arthroscopy 36:862–871

    Article  Google Scholar 

  9. Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163

    Article  Google Scholar 

  10. Lee JH, Park I, Hyun HS, Kim SW, Shin SJ (2019) Comparison of clinical outcomes and computed tomography analysis for tunnel diameter after arthroscopic Bankart repair with the all-suture anchor and the biodegradable suture anchor. Arthroscopy 35:1351–1358

    Article  Google Scholar 

  11. McCarty LP 3rd, Buss DD, Datta MW, Freehill MQ, Giveans MR (2013) Complications observed following labral or rotator cuff repair with use of poly-l-lactic acid implants. J Bone Jt Surg Am 95:507–511

    Article  Google Scholar 

  12. Milano G, Grasso A, Santagada DA, Saccomanno MF, Deriu L, Fabbriciani C (2010) Comparison between metal and biodegradable suture anchors in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 18:1785–1791

    Article  Google Scholar 

  13. Muller M, Kaab MJ, Villiger C, Holzach P (2002) Osteolysis after open shoulder stabilization using a new bio-resorbable bone anchor: a prospective, non-randomized clinical trial. Injury 33(Suppl 2):B30–B36

    Article  Google Scholar 

  14. Nakagawa S, Hirose T, Tachibana Y, Iuchi R, Mae T (2017) Postoperative recurrence of instability due to new anterior glenoid rim fractures after arthroscopic Bankart repair. Am J Sports Med 45:2840–2848

    Article  Google Scholar 

  15. Nho SJ, Provencher MT, Seroyer ST, Romeo AA (2009) Bioabsorbable anchors in glenohumeral shoulder surgery. Arthroscopy 25:788–793

    Article  Google Scholar 

  16. Park JY, Lee SJ, Oh SK, Oh K, Noh Y, Suh KT (2015) Glenoid rim fracture through anchor points after arthroscopic Bankart repair for shoulder instability. Int Orthop 39:241–248

    Article  Google Scholar 

  17. Petrera M, Patella V, Patella S, Theodoropoulos J (2010) A meta-analysis of open versus arthroscopic Bankart repair using suture anchors. Knee Surg Sports Traumatol Arthrosc 18:1742–1747

    Article  CAS  Google Scholar 

  18. Rhee YG, Lee DH, Chun IH, Bae SC (2004) Glenohumeral arthropathy after arthroscopic anterior shoulder stabilization. Arthroscopy 20:402–406

    Article  Google Scholar 

  19. Ruiz Iban MA (2017) Shoulder instability. Current concepts and controversies. Open Orthop J 11:810–811

    Article  Google Scholar 

  20. Ruiz Iban MA, Asenjo Gismero CV, Moros Marco S, Ruiz Diaz R, Del Olmo HT, Del Monte BG et al (2019) Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-019-05471-w

    Article  PubMed  Google Scholar 

  21. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428

    Article  CAS  Google Scholar 

  22. Take Y, Yoneda M, Hayashida K, Nakagawa S, Mizuno N (2008) Enlargement of drill holes after use of a biodegradable suture anchor: quantitative study on consecutive postoperative radiographs. Arthroscopy 24:251–257

    Article  Google Scholar 

  23. Tompane T, Carney J, Wu WW, Nguyen-Ta K, Dewing C, Provencher M et al (2018) Glenoid bone reaction to all-soft suture anchors used for shoulder labral repairs. J Bone Jt Surg Am 100:1223–1229

    Article  CAS  Google Scholar 

  24. Willemot L, Elfadalli R, Jaspars KC, Ahw MH, Peeters J, Jansen N et al (2016) Radiological and clinical outcome of arthroscopic labral repair with all-suture anchors. Acta Orthop Belg 82:174–178

    CAS  PubMed  Google Scholar 

  25. Woolnough T, Shah A, Sheean AJ, Lesniak BP, Wong I, de Sa D (2019) "Postage Stamp" fractures: a systematic review of patient and suture anchor profiles causing anterior glenoid rim fractures after Bankart repair. Arthroscopy 35:2501–2508

    Article  Google Scholar 

  26. Zou GY (2012) Sample size formulas for estimating intraclass correlation coefficients with precision and assurance. Stat Med 31:3972–3981

    Article  CAS  Google Scholar 

Download references

Funding

Neither the authors nor the institution received any funding directly or indirectly related to the scope of this study.

Author information

Authors and Affiliations

  1. Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain

    Miguel Angel Ruiz Ibán, Rosa Vega Rodriguez, Jorge Díaz Heredia, Roque Pérez Expósito, Irene Zarcos Paredes & Raquel Ruiz Díaz

Authors
  1. Miguel Angel Ruiz Ibán
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosa Vega Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jorge Díaz Heredia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roque Pérez Expósito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Irene Zarcos Paredes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Raquel Ruiz Díaz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miguel Angel Ruiz Ibán.

Ethics declarations

Conflict of interest

None of the authors have any conflict of interest regarding this research.

Ethical approval

The study was approved by the Institutional Review Board of Hospital Universitario Ramón y Cajal (Madrid, Spain, approval number 126-18).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ruiz Ibán, M.A., Vega Rodriguez, R., Díaz Heredia, J. et al. Arthroscopic Bankart repair with all-suture anchors does not cause important glenoid bone osteolysis: a volumetric CT study of 143 anchors. Knee Surg Sports Traumatol Arthrosc 29, 2152–2158 (2021). https://doi.org/10.1007/s00167-020-06192-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-020-06192-1

Keywords

Search

Navigation