title: Biomechanical Comparison of Arthroscopic Single- and Double-Row Repair Techniques for Acute Bony Bankart Lesions.
abstract: BACKGROUND
  Single- and double-row arthroscopic reconstruction techniques for acute bony Bankart lesions have been described in the literature.
  
  
  OBJECTIVE
  The double-row fixation technique would provide superior reduction and stability of a simulated bony Bankart lesion at time zero in a cadaveric model compared with the single-row technique.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Testing was performed on 14 matched pairs of glenoids with simulated bony Bankart fractures with a defect width of 25% of the glenoid diameter. Half of the fractures were repaired with a double-row technique, while the contralateral glenoids were repaired with a single-row technique. The quality of fracture reduction was measured with a coordinate measuring machine. To determine the biomechanical stability of the repairs, specimens were preconditioned with 10 sinusoidal cycles between 5 and 25 N at 0.1 Hz and then pulled to failure in the anteromedial direction at a rate of 5 mm/min. Loads at 1 mm and 2 mm of fracture displacement were determined.
  
  
  RESULTS
  The double-row technique required significantly higher forces to achieve fracture displacements of 1 mm (mean, 60.6 N; range, 39.0-93.3 N; P = .001) and 2 mm (mean, 94.4 N; range, 43.4-151.2 N; P = .004) than the single-row technique (1 mm: mean, 30.2 N; range, 14.0-54.1 N and 2 mm: mean, 63.7 N; range, 26.6-118.8 N). Significantly reduced fracture displacement was seen after double-row repair for both the unloaded condition (mean, 1.1 mm; range, 0.3-2.4 mm; P = .005) and in response to a 10-N anterior force applied to the defect (mean, 1.6 mm; range, 0.5-2.7 mm; P = .001) compared with single-row repair (unloaded: mean, 2.1 mm; range, 1.3-3.4 mm and loaded: mean, 3.4 mm; range, 1.9-4.7 mm).
  
  
  CONCLUSIONS
  The double-row fixation technique resulted in improved fracture reduction and superior stability at time zero in this cadaveric model.
  
  
  CONCLUSIONS
  This information may influence the surgical technique used to treat large osseous Bankart fractures and the postoperative rehabilitation protocols implemented when such repair techniques are used.
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA Department of Trauma and Orthopaedic and Plastic Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: Ulrich J
authors.initials: UJ
authors.lastname: Spiegl
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Smith
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Jocelyn N
authors.initials: JN
authors.lastname: Todd
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Garrett A
authors.initials: GA
authors.lastname: Coatney
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Coen A
authors.initials: CA
authors.lastname: Wijdicks
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA drmillett@thesteadmanclinic.com.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D050723:Fractures, Bone / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012540:Scapula / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*
keywords: arthroscopic repair; bony Bankart lesion; double-row repair; glenoid rim fracture; single-row repair