Arthroscopic Bony Bankart Repair

Arthroscopic stabilization has proven an effective technique in the treatment of anterior shoulder instability due to soft tissue labrum/ligamentous (i.e. Bankart) injury. However, this procedure has not proven as reliable in patients with glenoid rim fractures that have either been neglected or unrecognized, and gone on to resorb. Consequently, there has been a growing emphasis on the importance of preserving the glenoid’s bony rim anatomy, through recognition of it’s involvement, and development of techniques to treat bony Bankart pathology. When small, the avulsed fragment can be integrated into a “single-row” arthroscopic Bankart repair. Larger fragments however, are not as easily reduced or secured using conventional repair techniques. A recently described “double-row” or “bone bridge” technique, in which the bony Bankart lesion is secured via two points at each fixation site along the glenoid, has been shown to be biomechanically superior in restoring glenoid rim integrity, and is the preferred approach for dealing with significant bony Bankart lesions in anterior instability. When properly performed, arthroscopic shoulder stabilization yields predictable outcomes and high patient satisfaction rates in patients with bony Bankart lesions. clinical outcomes and high patient satisfaction in the treatment of bony Bankart lesions.