Arthroscopic Bankart Repair With and Without Curettage of the Glenoid Edge: A Prospective, Randomized, Controlled Study

Arthroscopy. 2021 Mar;37(3):837-842. doi: 10.1016/j.arthro.2020.11.042. Epub 2020 Nov 26.

Abstract

Purpose: To determine whether curettage of the cartilage on the glenoid edge in arthroscopic Bankart repair reduces the postoperative recurrence rate compared with noncuretted glenoid.

Methods: Between January 2010 and December 2013, 134 patients underwent arthroscopy and stabilization for recurrent anterior dislocation of shoulder; 42 patients were excluded. Alternate glenoid edge was curetted in 92 patients undergoing arthroscopic Bankart repair. Twelve patients were lost to follow-up. The remaining 80 patients were divided into 2 groups of 40 patients each, curettage and noncurettage. In both groups, the Bankart lesion was repaired using ≥3 bioanchors loaded with nonabsorbable braided sutures. Postoperative rehabilitation was the same for the 2 groups. We recorded recurrence of instability, pain, and Constant and Rowe shoulder scores. Statistical analysis of data was performed using unpaired t test (significance level P < .05).

Results: The 2 groups were comparable in terms of age, number of dislocations, and bone loss. The average follow-up was 7 years and 9 months (range 6 to 10 years). Of the total 40 patients in the curettage group, 6 (15%) had recurrence of dislocation and none had subluxations, whereas in the noncurettage group, 13 (32.5%) had recurrence of dislocation and 3 (7.5%) had subluxations. The difference in postoperative recurrence of instability was statistically significant (P = .012). The average (standard deviation) Rowe score was 83.75 (23.28) in the curettage group and 70.13 (31.29) in the noncurettage group (P = .030).

Conclusions: During arthroscopic Bankart repair, curettage of the cartilage on the anterior glenoid edge reduces the incidence of postoperative recurrence of instability.

Level of evidence: II, therapeutic; prospective, randomized, controlled study.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty
  • Arthroscopy
  • Bankart Lesions / surgery*
  • Curettage / methods*
  • Female
  • Humans
  • Joint Dislocations / surgery
  • Joint Instability / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Reconstructive Surgical Procedures
  • Recurrence
  • Scapula / surgery*
  • Shoulder / surgery
  • Shoulder Dislocation / surgery*
  • Shoulder Joint / surgery
  • Sutures
  • Young Adult