Modification of Bankart reconstruction with lateral capsulotomy and selective anatomic repair using suture anchors.

Twenty consecutive patients (17 male, 3 female) with a diagnosis of traumatic recurrent anterior instability of the shoulder were treated by a modified Bankart procedure using suture anchors. The technique consists of vertical incision of the capsule, just medial to the lateral insertion on the humerus and anatomic repair of the Bankart lesion. Humeral-based capsular shifting was performed in patients with anterior-inferior instability. The average age was 24 years (range: 14 to 39 years), and average follow-up period 68 months (range: 2 to 8 years). The average Bankart rating score was 92.5 (range: 70 to 100); with 16 (80%) excellent (score 90 to 100), 2 (10%) good (score 75 to 89), and 2 (10%) fair results. Failure in terms of recurrent dislocation was not reported. Eleven patients (55%) had a loss of 5 degrees to 10 degrees of external rotation either with the extremity at the side or at 90 degrees of abduction. Nine (45%) patients had external rotation equal to the contralateral side. We believe selective anatomic Bankart reconstruction by lateral capsulotomy and humeral-based capsular shifting in cases with marked inferior laxity is a more anatomic and physiologic technique.