Clinical Outcomes of an Improved Arthroscopic Suture‐Bridge Technique Assisted by a “5 O'clock” Portal for Acute Bony Bankart Lesions
Fan Jiang, Qing Yang, Chao Qi, Yi Zhang, Jinlong Ma, Tengbo Yu, Youliang ShenABSTRACT
Purpose
Bony Bankart lesion is a primary cause of traumatic shoulder instability. Although the arthroscopic suture bridge technique has been applied clinically, its operative complexity remains a challenge. This study aimed to evaluate the mid‐term clinical and radiological efficacy of a modified suture bridge technique combined with anchor insertion through a “5 o'clock” accessory portal for treating acute bony Bankart lesions.
Methods
This study retrospectively analyzed 36 patients with acute bony Bankart lesions who underwent the modified surgical treatment between January 2019 and February 2023. All patients were followed up for at least 2 years. Preoperative and final follow‐up assessments included VAS, Constant‐Murley, ASES, UCLA, and Rowe scores, as well as shoulder range of motion (ROM). Statistical analysis was performed using paired t ‐tests to compare preoperative and postoperative clinical scores and ROM. Fracture reduction and healing were assessed via CT 3D reconstruction at 6 months postoperatively.
Results
The mean follow‐up period was 28.8 months. At the final follow‐up, all clinical functional scores and ROM showed significant improvement compared to the preoperative status ( p < 0.001). CT 3D reconstruction at 6 months postoperatively showed successful reduction of the fracture fragment in all patients. The mean glenoid bone loss decreased from 18.2% ± 6.5% preoperatively to 2.5% ± 1.5% at follow‐up ( p < 0.001). The fracture healing rate was 97.2%. Eighty percent of patients successfully returned to a pre‐injury or higher level of sport. The redislocation rate was 2.8%, and the total complication rate was 5.6%.
Conclusion
The modified suture‐bridge technique using a “5 o'clock” accessory portal is a reliable and reproducible method for treating acute bony Bankart lesions. This approach achieves anatomical fracture reduction and yields excellent mid‐term clinical and radiological outcomes with a low risk of complications.