Abstract
Aim: To define the contact force and contact area at the glenoid labrum-bone interface between suture sites in an open transosseous Bankart repair, and to assess how these contact parameters are altered by tying adjacent sutures to each other.
Methods: Twelve capsulolabral avulsion lesions were created in fresh-frozen human shoulder specimens and were repaired using a standard transosseous suture technique. The contact forces and contact areas were measured at the labrum-bone interface between sutures before and after repair. Using the free suture ends, either a single or double strand knot was then tied between adjacent suture sites and the contact parameters were measured again.
Results: The contact forces and contact areas under the soft tissue bridges between transosseous sutures were mildly increased during repair (before repair: average force=5.53g, area=2.25mm2; after repair: force=11.7g, area=3.13mm2). However, both the contact forces and areas increased significantly when a single or double strand of suture was tied over the soft tissue bridge. The double strand technique resulted in a significantly greater increase in contact forces and areas than the single strand technique (single strand average force=70.1g, area=6.75mm2; double strand average force=95.15g, area=8.0mm2 p< 0.05).
Conclusions: The contact parameters between labrum and bone in a Bankart repair were increased when the suture strands from adjacent transosseous repair sites were linked. Increasing contact force or contact area may improve healing at the bone-soft tissue interface, and may reduce the risk of “spot welding” repairs. This, in turn, may reduce the failure rate of Bankart repairs.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
