Arthroscopic repair of combined Bankart and superior labral detachment anterior and posterior lesions: technique and preliminary results.

Over a 3-year period nine of 585 patients undergoing shoulder surgery were found to have a superior labral detachment anterior and posterior (SLAP) lesion. Seven patients also had an associated Bankart lesion and underwent arthroscopic repair of the entire anterior-inferior-superior-posterior labral detachment using the Suretac (Acufex Microsurgical Inc., Mansfield, MA) fixation device. The technique used requires an accessory anterior-lateral portal to access the superior-posterior labral detachment and an accessory anterior-inferior portal to access the Bankart lesion. Three to four Suretacs were required for repair in these cases. At an average follow-up of 19 months (range 15-22), five of seven patients had no pain, full range of motion, and a full premorbid activity level. One patient redislocated at 4 months postoperatively and was successfully managed with an open repair, and one patient developed a stiff shoulder that was successfully managed with arthroscopic release and manipulation. We conclude that this arthroscopic technique is a useful method to manage extensive labral detachment in selected patients.