Modified Mason–Allen Knot for Arthroscopic Complex Bankart Lesion Repair in Recurrent Anterior Shoulder Instability

Abstract

The arthroscopic Bankart repair is a safe and reliable procedure for the treatment of recurrent shoulder instability for the well-indicated patient. Many repair techniques have been described to restore both labral height and width and recreate a dynamic concavity–compression effect. The modified Mason–Allen knot was first described for rotator cuff tear repair and consists of a horizontal mattress knot with a simple vertical stitch on the same anchor. The purpose of this work is to present the use of the modified Masen–Allen knot for the repair of the capsular labral complex during an arthroscopic Bankart procedure.

Technique Video

Video 1

In a complex capsulolabral lesion faced in recurrent anterior shoulder instability, the modified Mason–Allen stitch is useful to better restore both the height and width of the capsulolabral complex to recreate a dynamic concavity–compression effect. First, a modified Mason–Allen knot is performed on an all-suture double-loaded anchor positioned at the 5-o’clock position. It is composed of the association of a horizontal mattress knot with a passing of a superior and an inferior thread separated by 5 mm. An overlapping simple vertical stitch is passed over the mattress knot with the tread passed in the middle of the both anteriorly passed threads. The horizontal mattress knot and the simple vertical stitch can then be tied. The same procedure is repeated at the 3- or 4-o’clock position. If needed, a simple stitch can be used to treat the concomitant anterior extent of the lesion or a posterior capsulolabral lesion.