A NEW TECHNIQUE OF ARTHROSCOPIC STABILISATON AND EARLY RESULTS

Arthroscopic shoulder surgery is evolving rapidly and several methods of stabilisation have been described. We present a simple new technique which addresses both the Bankart lesion and the capsular stretching together with the short-term results. The technique can be performed using just one anterior working portal and one posterior viewing portal. The labrum and capsule are elevated from the anterior glenoid neck by sharp dissection. One suture anchor is placed at the half past four position. One suture limb is passed under the labrum at 6 o’clock, the other limb is passed under the labrum at 2 o’clock and the two ends are tied. This has a purse string effect, tightening the capsule in only the superior/inferior plane, which also creates a bumper of labrum at the anterior glenoid rim. This technique was used in 35 patients (36 shoulders) with recurrent antero-inferior instability due to a traumatic Bankart lesion. The patient group included 33 men and 2 women with mean age 25 years (16–49). They had sustained an average of 5 dislocations per shoulder (1 to 11). The cohort included 4 professional and 6 semi-professional sportsmen all of whom were involved in collision or overhead sports. All the patients were assessed by an independent investigator at an average of 14 months (6–48) post surgery. Only one patient developed recurrent instability. This occurred without sustaining trauma. The average postoperative Rowe score was 93 (55–100), Walch-Duplay score was 93 (70–100), and Constant score was 97 (77–100). 65% of patients returned to the same level of sports and all the professional athletes were able to resume full activities. In conclusion, this technique is simple in concept, straightforward to perform, and demonstrates excellent short-term results.