Restoring the labral height for treatment of Bankart lesions: a comparison of suture anchor constructs

Abstract

Purpose: The purpose of this study was to evaluate glenoid labral heights before injury and after repair with 2 suture anchors: (1) traditional suture anchor secured with knots and (2) knotless suture anchor.

Methods: Ten matched pairs of human cadaveric glenoids were examined. In each specimen the labrum was detached from the 3-o'clock position to the 6:30 clock position on the anteroinferior glenoid, and labral repair was performed with either (1) traditional Bio-SutureTak suture anchors (n = 10) (Arthrex, Naples, FL) or (2) knotless PushLock suture anchors (n = 10, contralateral side) (Arthrex). By use of a 3-dimensional digitizer, the labral height, measured from the deepest point of the glenoid articular surface to the highest tip of the labrum, was measured in all specimens before injury and after repair at the 3:30, 4:30, and 5:30 clock positions. The degree of labral height increase was computed as a percent increase in labral height from before injury to after repair.

Results: Labral height increased significantly for all specimens from before injury (5.35 mm) to after repair (8.05 mm) (159.1% +/- 13.7%, P < .0001). Increases in labral height from before injury to after repair were similar (P > .05) for Bio-SutureTak suture anchors (164.6% +/- 18.7%, P < .0001) and PushLock suture anchors (153.6% +/- 5.8%, P < .0001). The amount of labral height increase did not vary by anatomic location (157.0% +/- 50.2%, 168.9% +/- 51.0%, and 150.4% +/- 35.2% at 3:30, 4:30, and 5:30, respectively; P = .46).

Conclusions: An increase in labral height can be achieved to create a significant height increase from before injury to after labral repair. The difference in labral height afforded by a traditional suture anchor and a knotless anchor is not statistically significant.

Clinical relevance: Both traditional and knotless suture anchor constructs provide a reliable restoration of labral height in an acute Bankart model.

Figures

Figure 1

(C) Labral height was determined as the shortest z-coordinate distance from a tangential line drawn through (A) the deepest point of the glenoid articular surface to (B) the tip of the labrum at each of the clock positions.

Figure 2

(A) Labral repair with BSTs at 3-, 4-, and 5-o’clock positions of a right glenoid. (B) Labral repair with PL anchors at 8-, 7-, and 6-o’clock positions of a left glenoid.

Figure 3

(A) Glenoid labrum before injury. The intact labrum is seen on the far right. (B) Glenoid labrum after repair with BSTs.

Figure 4

(A) Labral heights (in millimeters) before injury and after repair for specimens repaired with traditional suture anchors (BSTs). (B) Labral heights (in millimeters) before injury and after repair for specimens repaired with knotless suture anchors (PLs). Labral heights were significantly increased from before injury to after repair for both BSTs (P < .0001) and PLs (P < .0001).

Figure 5

Comparison of BST and PL repairs at each clock position along labrum. No significant differences were observed between BSTs and PLs at any of the 3 positions (P = .260 at 3:30, P = .818 at 4:30, and P = .971 at 5:30).