Glenoid Retroversion: Is It an Independent Risk Factor for Failure After Arthroscopic Bankart Repair?

A team of researchers and orthopaedic surgeons from the UPMC Department of Orthopaedic Surgery, in collaboration with other health systems (recognized below), published a study to determine whether glenoid retroversion is an independent risk factor for failure after arthroscopic Bankart repair. From UPMC, two surgeons with extensive experience in sports-related injuries of the shoulder took part — Bryson Lesniak, MD, Albert Lin, MD, along with research technician Gillian Kane.

The study was a retrospective review of patients with a minimum two-year follow-up. In part one of the study, individuals with no glenoid bone loss on magnetic resonance imaging (MRI) and who failed arthroscopic Bankart repair (cases) were compared with individuals who did not fail Bankart repair (controls).

In part two of the study, cases with subcritical (<20%) glenoid bone loss as measured on sagittal T1 MRI sequences who failed arthroscopic Bankart repair were compared to controls who did not. For each part of the study, glenoid version was measured using axial T2 MRI sequences.

Positive angular measurements were designated to represent glenoid anteversion, whereas negative measurements were designated to represent glenoid retroversion. Independent t tests were conducted to determine the association between glenoid version and failure after arthroscopic Bankart repair.

There were 20 cases and 40 controls in part one of the study and 19 cases and 21 controls in part two. There was no difference in baseline characteristics between cases and controls. Among individuals with no glenoid bone loss, there was no difference in glenoid version between cases and controls (cases: 6.0° ± 8.1° vs controls: 5.1° ± 7.8°, P = .22).

Among individuals with subcritical bone loss, cases (3.8° ± 4.4°) were associated with significantly less mean retroversion compared with controls (7.1° ± 2.8°, P = .0085). Decreased retroversion (odds ratio 1.34; 95% confidence interval 1.05-1.72, P = 20) was a significant independent predictor of failure using univariable logistic regression.

The team concluded that while glenoid retroversion is not associated with failure after arthroscopic Bankart repair in individuals with no glenoid bone loss, decreased retroversion is associated with failure in individuals with subcritical bone loss.

Read more about the study here.

Collaborators not affiliated with the University of Pittsburgh:

Ryan T. Li, MD 
WakeMed Health and Hospitals

Andrew Sheean, MD
San Antonio Military Medical Center

Kevin Wilson, MD
Mount Nittany Health

Darren de SA, MD
McMaster University