title: A biomechanical analysis of a single-row suture anchor fixation of a large bony bankart lesion.
abstract: OBJECTIVE
  This study was conducted to assess whether a single-row suture anchor repair of a bony Bankart lesion comprising 19% of the glenoid length restores peak translational force and glenoid depth compared with the intact shoulder.
  
  
  METHODS
  Nine thawed adult cadaveric shoulders were dissected and mounted in 45° of abduction and 30° of external rotation. A bony Bankart lesion was simulated with an anterior longitudinal osteotomy, parallel to the superoinferior axis of the glenoid, equivalent to 19% of the glenoid length. The humeral head was displaced 10 mm anteriorly at a speed of 2 mm/s with a 50-N compressive load applied. Testing was performed with the glenoid intact, a simulated lesion, and the lesion repaired with 3 single-row suture anchors. Median (interquartile range [IQR]) peak translational force and glenoid depth were reported. The Friedman test and post hoc comparisons with the Wilcoxon signed rank test were used for between-group analyses.
  
  
  RESULTS
  Peak translational force decreased after osteotomy (13.7 N; IQR, 9.6 to 15.5 N; P = .01) and increased after the repair (18.3 N; IQR, 18.3 to 20.6 N; P = .01) compared with the intact shoulder (23.7 N; IQR, 16.4 to 29.9 N). Glenoid depth significantly decreased after the osteotomy (0.2 mm; IQR, -0.6 to 0.7 mm) compared with baseline (1.7 mm; IQR, 1.3 to 2.0 mm; P = .01) and increased after repair (0.8 mm; IQR, 0.1 to 1.0 mm; P = .03) compared with the osteotomized shoulder. The glenoid depth of the repair was less than the baseline value (P = .01).
  
  
  CONCLUSIONS
  Repair of an anterior bony Bankart lesion equivalent to 19% of the glenoid length with 3 suture anchors restored the peak translational force needed to anteriorly displace the humerus relative to the glenoid; however, this technique failed to restore the natural glenoid depth in a laboratory setting.
  
  
  CONCLUSIONS
  Our findings describe the inability of a single-row suture anchor repair to provide anatomic fixation of the bony Bankart lesion equivalent to 19% of the glenoid length.
authors.affiliation: Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, New York, U.S.A.. Electronic address: evgenydy@buffalo.edu.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Dyskin
authors.affiliation: Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, New York, U.S.A.
authors.forename: John M
authors.initials: JM
authors.lastname: Marzo
authors.affiliation: Kenneth A. Krackow Orthopaedic Research Laboratory, University at Buffalo, Buffalo, New York, U.S.A.
authors.forename: Craig
authors.initials: C
authors.lastname: Howard
authors.affiliation: Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, New York, U.S.A.; Kenneth A. Krackow Orthopaedic Research Laboratory, University at Buffalo, Buffalo, New York, U.S.A.; Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, U.S.A.
authors.forename: Mark
authors.initials: M
authors.lastname: Ehrensberger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D058430:Humeral Head; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D012399:Rotation; D012783:Shoulder Dislocation / Q000601:surgery; D012784:Shoulder Fractures / Q000503:physiopathology / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D053441:Suture Anchors