Our Summary

This study is about a new way of fixing a common shoulder injury known as a Bankart lesion. This injury occurs when a part of the shoulder joint (the labrum) gets torn, causing instability and pain. The traditional way of fixing this is by stitching the torn part back onto the bone, but this method might not provide enough stability.

A newer technique involves creating a “double-row” or “double pulley” of stitches, which can provide more stability. However, this method has been further improved with the use of knotless anchors and an all-suture technique. This means that instead of tying knots, the surgeons use special anchors that hold the stitches in place without needing knots.

The procedure involves five steps. First, the surgeon cleans up the joint and prepares it for the repair. Then, they place the first anchor as low as possible on the shoulder joint. The next two anchors are placed in specific positions, and finally, the stitches are tied in a particular way to create a bridge over the torn area.

This technique is beneficial as it allows for maximum contact and compression between the torn part and the bone, which can improve healing. It also makes it easier to deal with difficult corners in the shoulder joint. This research could potentially improve the outcomes for patients undergoing shoulder surgery.

FAQs

  1. What is a Bankart lesion and how is it traditionally fixed?
  2. What is the “double-row” or “double pulley” method for labral repair?
  3. How does the use of knotless anchors and an all-suture technique improve the procedure for labral repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair using this technique is to follow their post-operative rehabilitation plan carefully. This may include physical therapy exercises to strengthen and stabilize the shoulder joint, as well as instructions on how to properly care for the surgical site to promote healing. It is important for patients to communicate any pain or discomfort to their healthcare provider and to attend all follow-up appointments to ensure the best possible outcome from the surgery.

Suitable For

Patients who are typically recommended labral repair include:

  1. Individuals who have experienced a Bankart lesion or labral tear in the shoulder joint, causing instability and pain.
  2. Patients who have not responded to conservative treatments such as physical therapy or medication.
  3. Athletes or active individuals who require a high level of shoulder stability for their activities.
  4. Patients with recurrent shoulder dislocations or subluxations.
  5. Individuals with significant damage to the labrum that is affecting their daily activities and quality of life.

Overall, patients who are experiencing shoulder instability and pain due to a labral tear may benefit from labral repair surgery using the techniques described in this study.

Timeline

Before labral repair:

  1. Patient experiences shoulder pain, instability, and limited range of motion.
  2. Patient undergoes diagnostic tests such as MRI to confirm a Bankart lesion.
  3. Orthopedic surgeon recommends labral repair surgery as the best treatment option.

After labral repair:

  1. Patient undergoes labral repair surgery using the new knotless anchor technique.
  2. Surgeon creates a double-row or double pulley of stitches to provide more stability.
  3. Patient goes through post-operative rehabilitation to regain strength, range of motion, and stability in the shoulder.
  4. Patient experiences improved shoulder function, reduced pain, and increased overall quality of life.

What to Ask Your Doctor

  • What are the risks and benefits of the traditional method of labral repair compared to the newer technique with knotless anchors?
  • How long is the recovery time for each method?
  • Will I need physical therapy after surgery, and if so, for how long?
  • What is the success rate of the newer technique with knotless anchors compared to the traditional method?
  • Are there any specific restrictions or limitations I should follow after surgery?
  • What should I expect in terms of pain management after the procedure?
  • How soon can I return to my normal activities, such as sports or heavy lifting, after surgery?
  • What type of follow-up care will be necessary after the procedure?
  • Are there any potential long-term effects or complications associated with either method of labral repair?
  • How many times have you performed this newer technique with knotless anchors, and what is your success rate?

Reference

Authors: Loh B, Lie DTT. Journal: Video J Sports Med. 2021 Aug 26;1(4):26350254211016468. doi: 10.1177/26350254211016468. eCollection 2021 Jul-Aug. PMID: 40309388