Arthroscopic Repair of Anterior Labroligamentous Periosteal Sleeve Avulsion Lesions Achieves Similar Outcomes and Labral Height Compared With Typical Bankart Lesions With Adequate Capsulolabral Release

Abstract

Purpose To compare the serial measurements of repaired labral height in the early and late postoperative periods and clinical outcomes between patients with Bankart lesions and those with anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions during the study period. Methods This retrospective comparative study evaluated patients who underwent arthroscopic Bankart repair for ALPSA or Bankart lesions between September 2016 and October 2022. Inclusion criteria were glenoid defect less than 20% on 3-dimensional computed tomography, minimum 2-year follow-up, and availability of computed tomography arthrography at 3 weeks and 6 months postoperatively. Functional assessments included subjective shoulder value, Rowe score, and University of California Los Angeles shoulder score, and range of motion. Radiological assessment measured labral height on computed tomography arthrography at 3 and 6 months postoperatively. Results Of 336 patients, 246 met the inclusion criteria with 67 ALPSA lesions (Group A) and 179 Bankart lesions (Group B). Mean follow-up was 41.4 +/- 11.6 months (range 24-68 months) in Group A and 44.2 +/- 11.3 months (range 24-73 months) in Group B (P = .089). There were no significant differences between the groups in terms of the preoperative and final follow-up active range of motion. The mean subjective shoulder value, Rowe score, and University of California Los Angeles shoulder score significantly improved in both groups (P < .001), with no significant differences between the groups. All patients achieved the minimal clinically important difference for subjective shoulder value and University of California Los Angeles scores. The mean postoperative labral heights at 3 weeks and 6 months were 6.3 +/- 0.8 and 5.7 +/- 0.8 mm in Group A and 6.1 +/- 0.9 and 5.4 +/- 1.0 mm in Group B, respectively, with no significant difference between the groups. Conclusions Arthroscopic Bankart repair for ALPSA lesions resulted in labral height restoration comparable with typical Bankart lesions at both early and late follow-up, with similar functional outcomes and similarly low recurrence rates.