Anchor Hole Placement for Bankart Repairs and Its Interaction With Variable Size Hill –Sachs Defects-Minimizing Risk of Glenoid Rim Fractures

This study used finite element modeling techniques to investigate the risk of fracture of the glenoid rim in relation to variable sized Hill–Sachs defects impacting on the anterior glen oid edge with suture anchor holes placed in varying positions. The distribution of Von Mises (VM) stresses and the factor of safety (FOS) for each of the configurations were calculated. The greatest peak in VM stresses was generated when the glenoid was loaded with a small Hill–Sachs lesion. The V M stresses were lessened and the FOS increased (reducing likelihood of failure) with increasing size of the Hill–Sachs lesion. Placement of the suture drill holes at 2 mm from the glenoid rim showed the highest risk of failure; and when combined with a medium sized Hill–Sachs lesion, which mat ched the central line of the drill holes, a potentially clinically significant configuration was presented. The results of this study are useful in assisting the surgeon in understanding the interaction between the Hill–Sachs lesion size and the placement of suture anchors with the purpose of mini mizing the risk of subsequent rim fracture with new injury.
Source: Journal of Biomechanical Engineering - Category: Biomedical Engineering Source Type: research