Radiological evaluation of glenoid bone reaction following arthroscopic Bankart repair using all-soft suture anchors

Objectives Glenohumeral instability is one of the most common orthopedic problems encountered in the clinical practice. Anterior shoulder instability accounts for 90% of total cases of shoulder instability. Bankart lesion (Avulsion of anteroinferior glenoid labrum) occurs as a sequela to anterior dislocation in the majority of cases, which, in turn, predisposes to recurrent shoulder instability. Arthroscopic Bankart repair using all-soft suture anchors is currently being considered as an advanced method in the management of Bankart lesions due to the better understanding of pathology behind the recurrent instability and greater experience among surgeons regarding the usage of suture anchors. Our study focused on assessing radiological outcomes following the implantation of all-soft suture anchors using advanced radiological imaging (computed tomography [CT]) in the post-operative period. Materials and Methods We used 43 all-soft suture anchors (24 single-loaded and 19 double-loaded) in 15 patients managed by arthroscopic Bankart repair. The suture anchors were assessed radiologically using CT at regular intervals (6 and 12 months). The peri-implant changes (Glenoid Bone reactions) in the post-operative period were assessed as per the study conducted by Tompane et al . and Ruiz Ibán et al . Results In our study, none of the anchors showed complete resorption or grade 0 changes. Partial bony defect or erosions were identified in 14 out of 43 anchors and 21 out of 43 anchors in the first and second CT, respectively. We found tunnel dilation or grade 2 changes in 26 anchors in first CT which reduced to 19 in the second CT. Three peri-anchor cystic lesions were identified in the first CT which remained the same on subsequent serial imaging. Conclusion Overall performance of all-soft suture anchors in arthroscopic Bankart repair is comparable to that of previous generation suture anchors in terms of clinical and functional outcomes. Serial radiological assessment (CT-based) of all-soft suture anchors following implantation showed some changes in the glenoid bone following insertion, which showed a tendency toward healing on serial evaluation in the majority of cases.