HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zarins, B. Articles by Karlsson, J. Search for Related Content PubMed PubMed Citation Articles by Zarins, B. Articles by Karlsson, J.

Letter to the Editor

Boston, Massachusetts

Dear Editor:

Regarding the article entitled "Revisiting the Open Bankart Experience. A Four- to Nine-Year Follow-up" (November/December 2002, pages 778 to 782), the authors report a 17% failure rate after open Bankart procedure. The authors state that "The only exception to the original technique was that suture anchors were used instead of curved drill holes . . . ." I believe this is a critical difference in technique and probably explains the high failure rate in this series.

I tried using suture anchors for Bankart repairs more than 10 years ago. With this revised method of fixation of the capsule to the glenoid rim, my patients had a higher failure rate than those patients in whom I had used the curved drill holes as described by Carter Rowe. I discontinued using anchors and again had a low recurrence rate when performing open Bankart repairs.

I believe that curved drilled holes through the glenoid rim allow for better fixation of the capsule to the glenoid rim because they fix a larger surface area. Although repairs with suture anchors are easier to perform, I recommend against the use of suture anchors in open Bankart repairs.

Author’s Response:

Trollhättan, Sweden

In Sweden, shoulder reconstructive surgery has been greatly influenced by the work of Hovelius et al.^1–3 Until the 1980s, one of the most commonly used methods in Sweden was the Bristow-Latarjet procedure. However, because of the restriction of external rotation and a failure rate, including subluxations, of 13%,² there was increased interest in a more anatomic type of reconstruction. Because the original Bankart procedure was considered a difficult operation,³ many surgeons started using the modified technique involving suture anchors.⁴ It is our belief that, worldwide, suture anchors are more often used than curved drill holes; therefore, the results of our study are of interest. Furthermore, we must admit that the results of our study have made us reconsider the use of our procedures, both arthroscopic and open.

Dr. Zarins has pointed out that the use of curved drill holes produces better results after open Bankart reconstruction than does the use of suture anchors. The idea of both procedures is to re-create the anterior capsulolabral complex, and it may be that the use of curved drill holes renders a more aggressive shift of tissue. Unfortunately, we have not had the opportunity to perform a controlled study comparing these two techniques because of the limited use of the procedure using curved drill holes at our institutions.

However, we agree with Dr. Zarins that this type of information and discussion is important. We therefore encourage him to report the independent long-term results of the open Bankart procedure using curved drill holes.

REFERENCES

1. Hovelius L, Åkermark C, Albrektsson B, et al: Bristow-Latarjet procedure for recurrent anterior dislocation of the shoulder. A 2–5 year follow-up study on the results of 112 cases. Acta Orthop Scand 54:284 –290,1983[Medline][Order article via Infotrieve]
2. Hovelius L, Körner L, Lundberg B, et al: The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure. J Bone Joint Surg 65A:926 –934,1983[Abstract/Free Full Text]
3. Hovelius L, Thorling J, Fredin H: Recurrent anterior dislocation of the shoulder. Results after the Bankart and Putti-Platt operations. J Bone Joint Surg 61A:566 –569,1979[Abstract/Free Full Text]
4. Richmond JC, Donaldson WR, Fu F, et al: Modification of the Bankart reconstruction with a suture anchor. Report of a new technique. Am J Sports Med 19:343 –346,1991[Abstract/Free Full Text]

This article has been cited by other articles:

				J. G. Hurbanek, K. Anderson, S. Kaatz, A. Shepard, M. Workings, and K. Rand Ulnar Deep Venous Thrombosis in a Professional Baseball Pitcher: A Case Report Am. J. Sports Med., December 1, 2007; 35(12): 2131 - 2134. [Full Text] [PDF]

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zarins, B. Articles by Karlsson, J. Search for Related Content PubMed PubMed Citation Articles by Zarins, B. Articles by Karlsson, J.