title: Clinical Outcome and Glenoid Morphology After Arthroscopic Repair of Chronic Osseous Bankart Lesions: A Five to Eight-Year Follow-up Study.
abstract: BACKGROUND
  Arthroscopic osseous Bankart repair for shoulders with chronic recurrent anterior instability has been reported as an effective procedure with promising short-term outcomes. However, to date, we know of no report describing longer-term outcomes and glenoid morphologic change. The purpose of the present study was to report intermediate to long-term outcomes and glenoid morphologic change after arthroscopic osseous Bankart repair in patients with substantial glenoid bone loss.
  
  
  METHODS
  A consecutive series of eighty-five patients with traumatic anterior glenohumeral instability associated with a chronic osseous Bankart lesion underwent arthroscopic repair from January 2005 through December 2006. Forty-six patients with bone loss of >15% of the inferior glenoid diameter relative to the assumed inferior circle regardless of the fragment size were selected as candidates for this study. Thirty-eight patients (83%), including thirty-four male and four female patients, with a mean age of 23.4 years (range, fifteen to thirty-six years) at the time of surgery, were available for final follow-up at a mean of 6.2 years (range, 5.0 to 8.1 years) after surgery.
  
  
  RESULTS
  One patient had a redislocation during a traffic accident five months after surgery before obtaining an osseous union. The mean Rowe score and the mean Western Ontario Shoulder Instability Index improved significantly from 30.7 points preoperatively to 95.4 points postoperatively and from 26.5% to 81.5%, respectively. Although the mean preoperative fragment size was measured as only 4.7%, the mean glenoid bone loss improved from 20.4% preoperatively to -1.1% postoperatively.
  
  
  CONCLUSIONS
  Arthroscopic osseous Bankart repair is an effective primary treatment for shoulders with substantial glenoid bone loss as it provides successful outcomes without recurrence of instability once osseous union is obtained. Glenoid morphology can be normalized during the intermediate to long-term postoperative period, even in shoulders with a smaller fragment.
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kitayama
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugaya
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Matsuki
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kawai
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Morihito
authors.initials: M
authors.lastname: Tokai
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Ohnishi
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi 2740822, Japan. E-mail address for H. Sugaya: hsugaya@nifty.com.
authors.forename: Shota
authors.initials: S
authors.lastname: Hoshika
authors.affiliation: Department of Sports Medicine and Joint Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 0608638, Japan. E-mail address for N. Kitamura: nokita@med.hokudai.ac.jp. E-mail address for K. Yasuda: yasukaz@med.hokudai.ac.jp.
authors.forename: Nobuto
authors.initials: N
authors.lastname: Kitamura
authors.affiliation: Department of Sports Medicine and Joint Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 0608638, Japan. E-mail address for N. Kitamura: nokita@med.hokudai.ac.jp. E-mail address for K. Yasuda: yasukaz@med.hokudai.ac.jp.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yasuda
authors.affiliation: Ichikawa Clinic, Funabashi Orthopaedic Hospital, 1-10-1-206 Ichikawa-minami, Ichikawa 2720033, Japan. E-mail address: moriishi@fff.or.jp.
authors.forename: Joji
authors.initials: J
authors.lastname: Moriishi
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D061165:Glenoid Cavity / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult