Arthroscopic Bankart repair and subscapularis augmentation: an alternative technique treating anterior shoulder instability with bone loss

J Shoulder Elbow Surg. 2016 Jun;25(6):898-906. doi: 10.1016/j.jse.2015.09.025. Epub 2015 Nov 21.


Background: This study presents the preliminary results of a new arthroscopic technique consisting of the association of 2 procedures, capsulolabral repair and subscapularis augmentation tenodesis, in the treatment of traumatic anterior shoulder instability with both glenoid bone loss and a Hill-Sachs lesion.

Methods: Eighty-nine patients engaged in sports were enrolled in this retrospective case-series study with 2 to 5 years' follow-up. All patients underwent a computed tomography scan to assess the percentage of glenoid bone loss by the Pico method. A prior stabilization procedure had failed in 20 patients, who were then segregated into a different group. Visual analog scale (VAS), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores were used to assess the results.

Results: Only 3 of 89 patients had a post-traumatic redislocation. The mean length of follow-up was 31.5 months (range, 25-60 months). The VAS, Rowe, and ASES scores showed significant improvements: The VAS score decreased from a mean of 3.1 to 0.5 (P = .0157), the Rowe score increased from 58.9 to 94.1 (P = .0215), and the ASES score increased from 68.5 to 95.5 (P = .0197). The mean deficit of external rotation was 6° with the arm at the side of the trunk, and the mean deficit was 3° with the arm in 90° of abduction.

Conclusions: The described procedure is a reproducible and effective technique used to restore joint stability in patients engaged in sports who have incurred anterior recurrent shoulder dislocation associated with glenoid bone loss (<25%) and a Hill-Sachs lesion.

Keywords: Hill-Sachs lesion; Traumatic shoulder instability; arthroscopic subscapularis augmentation; glenoid defect.

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty / methods*
  • Arthroscopy
  • Athletic Injuries / surgery
  • Bone Resorption / surgery*
  • Female
  • Fibrocartilage / surgery
  • Humans
  • Joint Capsule / surgery
  • Joint Instability / surgery*
  • Male
  • Recurrence
  • Retrospective Studies
  • Rotator Cuff / surgery*
  • Scapula / surgery
  • Shoulder Dislocation / surgery*
  • Shoulder Joint / surgery*
  • Tenodesis / methods
  • Treatment Outcome
  • Young Adult