Curved-guide System Is Useful in Achieving Optimized Trajectory for the Most Inferior Suture Anchor During Arthroscopic Bankart Repair

J Shoulder Elbow Surg. 2019 Sep;28(9):1692-1698. doi: 10.1016/j.jse.2019.03.031.

Abstract

Background: A curved-drill guide system was recently introduced to achieve a better trajectory for a low anteroinferior anchor during arthroscopic Bankart repair. However, the clinical performance of such a device remains unclear. The purpose of this study was to evaluate the trajectory and position of the low anteroinferior suture anchor with use of the curved-guide system in clinical cases.

Methods: We enrolled 41 cases of arthroscopic Bankart repair in this study. Of these cases, 9 were repaired using the curved drill guide whereas 32 were repaired using a conventional straight guide. Postoperative computed tomography scans were obtained, and 3-dimensional models of the scapula were reconstructed. Notable perforations of the opposite cortex by the most inferior anchors were recorded. The clock-face angle, insertion angle, and insertion distance were measured.

Results: The anchor perforation rate in the curved-guide group (11%) was significantly lower than that in the straight-guide group (56%) (P = .02). The insertion distance in the curved-guide group was significantly shorter than that in the straight-guide group (4.0 ± 1.6 mm vs. 7.0 ± 2.4 mm, P < .01). The clock-face angle and insertion angle were significantly greater in the perforated straight-guide group than in the nonperforated groups. The percentage of anchors in the absolute safe zone (clock-face angle > 135° and < 165° and insertion angle < 100°), where no anchors perforated, was greater in the curved-guide group than the straight-guide group.

Conclusion: Compared with the conventional straight guide, the curved-guide system provides better placement of the most inferior suture anchor during arthroscopic Bankart repair.

Keywords: 3D reconstruction; Arthroscopic Bankart repair; anchor perforation; anchor trajectory; curved-guide system; most inferior suture anchor.

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy / methods*
  • Bankart Lesions / surgery*
  • Cohort Studies
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scapula / diagnostic imaging
  • Shoulder Dislocation / surgery
  • Suture Anchors*
  • Tomography, X-Ray Computed
  • Young Adult