Shaha and colleagues tested whether on‑track or off‑track status on preoperative MRI predicts failure of arthroscopic Bankart repair, and whether it does so better than glenoid bone loss alone.
57 of 70 active‑duty service members with complete outcomes after primary arthroscopic Bankart repair by 3 surgeons, mean follow‑up 48.3 months.
Key Findings
Repair failed in 6 of 8 off‑track shoulders (75%) vs 4 of 49 on‑track shoulders (8%).
Off‑track status had a positive predictive value of 75%, vs 44% for glenoid bone loss over 20%. The negative predictive value of on‑track status was 92%.
In the 30 shoulders with a Hill‑Sachs lesion, track status predicted stability correctly in 27 (90%) vs 22 (73%) for the 20% bone‑loss cutoff. This difference was not significant.
Without a Hill‑Sachs lesion (27 shoulders, on‑track by definition), 3 failed. Only 2 of 7 with over 20% glenoid bone loss failed, a significantly worse prediction than the track (p = 0.01).
Mean WOSI was worse in off‑track than on‑track shoulders (1,134 vs 668 points, p = 0.011), and worse with recurrence (p = 0.003).
The study was retrospective in a young military cohort, and too small to show the track's superiority within the bipolar subgroup alone.
Authors' conclusion
The application of the glenoid track concept to our cohort was superior to using glenoid bone loss alone with regard to predicting postoperative stability. This method of assessment is encouraged as a routine part of the preoperative evaluation of all patients under consideration for arthroscopic anterior stabilization.
Shaha and colleagues tested whether on‑track or off‑track status on preoperative MRI predicts failure of arthroscopic Bankart repair, and whether it does so better than glenoid bone loss alone.
57 of 70 active‑duty service members with complete outcomes after primary arthroscopic Bankart repair by 3 surgeons, mean follow‑up 48.3 months.
Key Findings
Repair failed in 6 of 8 off‑track shoulders (75%) vs 4 of 49 on‑track shoulders (8%).
Off‑track status had a positive predictive value of 75%, vs 44% for glenoid bone loss over 20%. The negative predictive value of on‑track status was 92%.
In the 30 shoulders with a Hill‑Sachs lesion, track status predicted stability correctly in 27 (90%) vs 22 (73%) for the 20% bone‑loss cutoff. This difference was not significant.
Without a Hill‑Sachs lesion (27 shoulders, on‑track by definition), 3 failed. Only 2 of 7 with over 20% glenoid bone loss failed, a significantly worse prediction than the track (p = 0.01).
Mean WOSI was worse in off‑track than on‑track shoulders (1,134 vs 668 points, p = 0.011), and worse with recurrence (p = 0.003).
The study was retrospective in a young military cohort, and too small to show the track's superiority within the bipolar subgroup alone.
Authors' conclusion
The application of the glenoid track concept to our cohort was superior to using glenoid bone loss alone with regard to predicting postoperative stability. This method of assessment is encouraged as a routine part of the preoperative evaluation of all patients under consideration for arthroscopic anterior stabilization.