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Cheng X, Wang H, Jiang Y, Shao Z, Cui G. The New Double-row Bankart Repair Recovered Shoulder Stability without Excessive Motion Limitation: A Case-Control Study with Single-row Bankart Repair. Orthop Surg 2024; 16:1073-1078. [PMID: 38488263 PMCID: PMC11062857 DOI: 10.1111/os.14032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVES Bankart lesion is one of the most common lesions of the glenohumeral joint. Several double-row suture methods were reported for Bankart repair, which could provide more stability, yet more motion limitation and complications. Therefore, we introduced a new double-row Bankart repair technique, key point double-row suture which used one anchor in the medial line. The purpose of this article is to investigate the clinical outcomes of this new method and to compare it with single-row suture. METHODS Seventy-eight patients receiving key point double-row suture or single-row suture from October 2010 to June 2014 were collected retrospectively. The basic information including gender, age, dominant arm, and number of episodes of instability was collected. Before surgery, the glenoid bone loss was measured from the CT scan. The visual analogue scale, American shoulder and elbow surgeons, the University of California at Los Angeles shoulder scale, and subjective shoulder value were valued before surgery and at the last follow-up. RESULTS Forty-four patients (24 patients receiving single-row suture and 20 patients receiving key point double-row suture) were followed up successfully. The follow-up period was 9.2 ± 1.1 years (range, 7.8-11.4 years). At the last follow-up, no significant differences were detected for any of the clinical scores. The recurrence rate was 12.5% for the single-row group and 10% for the double-row group, respectively (p = 0.795) 14 patients (31.8%) in the single-row group and nine patients (26.5%) in the double-row group were tested for active range of motion. A statistically significant difference was found only for the internal rotation at 90° abduction (48.9° for single-row and 76.7° for key point double-row, p = 0.033). CONCLUSION The key point double-row sutures for Bankart lesions could achieve similar long-term outcomes compared with single-row suture, and one medial anchor did not result in a limited range of motion. The low recurrence rate and previous biomechanical results also indicate the key point double-row suture is a reliable method.
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Affiliation(s)
- Xu Cheng
- Department of Sports MedicinePeking University Third Hospital, Institute of Sports Medicine of Peking UniversityBeijingChina
- Beijing Key Laboratory of Sports InjuriesBeijingChina
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of EducationBeijingChina
| | - Hangle Wang
- Department of Sports MedicinePeking University Third Hospital, Institute of Sports Medicine of Peking UniversityBeijingChina
- Beijing Key Laboratory of Sports InjuriesBeijingChina
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of EducationBeijingChina
| | - Yanfang Jiang
- Department of Sports MedicinePeking University Third Hospital, Institute of Sports Medicine of Peking UniversityBeijingChina
- Beijing Key Laboratory of Sports InjuriesBeijingChina
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of EducationBeijingChina
| | - Zhenxing Shao
- Department of Sports MedicinePeking University Third Hospital, Institute of Sports Medicine of Peking UniversityBeijingChina
- Beijing Key Laboratory of Sports InjuriesBeijingChina
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of EducationBeijingChina
| | - Guoqing Cui
- Department of Sports MedicinePeking University Third Hospital, Institute of Sports Medicine of Peking UniversityBeijingChina
- Beijing Key Laboratory of Sports InjuriesBeijingChina
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of EducationBeijingChina
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Deng Z, Lu W, Liu C, Gao S, Wu L, Ye Y, Su J, Xu J. Surgical considerations for glenoid bone loss in anterior glenohumeral instability: a narrative review. Eur J Trauma Emerg Surg 2024; 50:395-403. [PMID: 37642655 DOI: 10.1007/s00068-023-02357-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Treatment algorithms may consider many factors like glenoid and humeral bone loss, or scores such as the instability severity index score (ISIS). As most studies only evaluate a part of these factors, there is still no evidence-based consensus estalished. Our study aims to summarize the surgical options for treatment of glenoid bone loss (GBL) in anterior shoulder instability. METHODS Based on the current available literature, surgical options including Bankart repair and glenoid bone augmentation should be considered while taking into consideration the degree of bone loss which has been divided into < 10%, 10-20% and > 20%. RESULTS There are many new techniques evolving including arthroscopic anatomic glenoid reconstruction with bone blocks. CONCLUSION Future long-term outcome studies and randomized controlled trials comparing established techniques will be needed for new evidence-based treatment algorithms.
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Affiliation(s)
- Zhenhan Deng
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Wei Lu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Cailong Liu
- Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Shuguang Gao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Lichuang Wu
- Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Yiheng Ye
- Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Jingyue Su
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong, China
| | - Jian Xu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China.
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Carnero-Martín de Soto P, Zurita-Uroz N, Tamimi-Mariño I, Calvo-Díaz Á. Long-Term Results of Arthroscopic Bankart Repair for Anterior Glenohumeral Instability: Does Associated Postero-inferior Capsulolabral Repair Still Have a Role? Indian J Orthop 2022; 56:1906-1912. [PMID: 36310561 PMCID: PMC9561489 DOI: 10.1007/s43465-022-00701-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To compare the outcomes of arthroscopic anterior Bankart repair with and without associated postero-inferior capsulolabral repair as treatment of anterior glenohumeral instabiliy at minimun 10 year follow-up. METHODS A retrospective comparative study including patients who underwent arthroscopic anterior Bankart repair to treat anterior glenohumeral instability with glenoid bone-loss < 15% between January 2000 and February 2010 was performed. Outcomes were reported as recurrence rate, type of recurrence (dislocation or subluxation), need for revision surgery, range of motion, complications, and functional status. Outcomes were compared depending on whether a postero-inferior capsulolabral repair was added to the anterior Bankart repair. RESULTS 70 shoulders [59 males, mean age 28.2 (range 14-56), mean follow-up 146.1 (range 120-208) months] were included. Recurrence occurred in 9 cases (12.8%), including 3 dislocations and 6 subluxations. Revision surgery was needed in 8 (11.4%). Mean Rowe score improved from 29.7 (11.6) preoperatively to 87.1 (12.3) postoperatively. 83.3% returned to previous sports activities. Mean forward flexion changed from 173.5° (19.2) to 168.4º(10.4) (P < 0.01), external rotation from 81.4° (18) to 75.7° (10.5) (P < 0.01), and internal rotation decreased from 66.2% reaching T12 to 14.1% (P < 0.01). Addition of postero-inferior capsulolabral repair did not influence any of the outcomes significantly. CONCLUSION Postero-inferior capsulolabral repair added to anterior Bankart repair as treatment of anterior glenohumeral instability in abscence of significant glenoid bone-loss did not influence the outcomes in terms of recurrence, range of motion, return to sports, or functional status, compared to isolated anterior Bankart repair at 12.2 year follow-up. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Pablo Carnero-Martín de Soto
- Arthrosport Zaragoza, Avenida Ruiseñores 20, 50006 Zaragoza, Spain
- Hospital Viamed Montecanal, Calle Franz Schubert 2, 500012 Zaragoza, Spain
| | | | - Iskandar Tamimi-Mariño
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Regional Universitario de Málaga, Avenida de Carlos Haya 84, 29010 Málaga, Spain
| | - Ángel Calvo-Díaz
- Arthrosport Zaragoza, Avenida Ruiseñores 20, 50006 Zaragoza, Spain
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Yildirim K, Pehlivanoglu T, Tandogan RN, Beyzadeoglu T. Safety, Efficacy, and Cost-Effectiveness of Simultaneous Bilateral Arthroscopic Bankart Repair for Bilateral Shoulder Instability. Orthop J Sports Med 2022; 10:23259671221098435. [PMID: 35647212 PMCID: PMC9134442 DOI: 10.1177/23259671221098435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Bilateral shoulder instability and Bankart lesions are not rare and
frequently require surgical treatment. Bilateral instability may be treated
with either a single-stage, simultaneous bilateral Bankart repair or 2-stage
surgery. Purpose/Hypothesis: To compare simultaneous bilateral arthroscopic Bankart repair to 2-stage
repair in terms of clinical outcomes and hospitalization costs. It was
hypothesized that simultaneous repair would provide clinical outcomes
similar to those of 2-stage Bankart repair while yielding lower
hospitalization costs. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent simultaneous bilateral arthroscopic Bankart repair
(group 1) were matched by age, sex, and injury type to control patients who
had unilateral Bankart repair (group 2). All patients were operated on by
the same surgeon in the same institution between 2007 and 2017 and had a
minimum follow-up duration of 24 months. Patients with inflammatory
arthritis, metabolic/malignant disease, previous shoulder surgery, a glenoid
bone loss ≥25%, or off-track Hill-Sachs lesion were excluded. The 2 groups
were compared in terms of pre- and postoperative Western Ontario Shoulder
Instability Index (WOSI) scores, hospitalization costs, complications, and
recurrent instability. The hospitalization cost of group 2 was multiplied by
2 to create a projection of the estimated cost of 2 sequential unilateral
Bankart repairs. Results: The study population comprised 48 patients (38 men [79.17%] and 10 women
[20.83%]; mean age, 25.5 years at surgery and 22.75 years at first
dislocation). Group 1 included 32 shoulders in 16 patients, while group 2
consisted of 32 shoulders in 32 patients. The mean hospitalization cost (in
2020 US dollars) was $26,010 ± $1455 for group 1 and $33,591 ± $1574 for
group 2 (P < .001). Both groups had improved WOSI scores
after surgery and achieved similar scores at the latest follow-up. There was
1 redislocation in each group (3.13%). No surgery- or
anesthesia-related/medical complications were recorded in either group. Conclusion: For bilateral shoulder instability, clinical outcomes of simultaneous
bilateral arthroscopic Bankart repair were similar to those of 2-stage
repair; however, lower hospitalization costs were seen after simultaneous
bilateral repair compared with 2-stage surgery.
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Affiliation(s)
- Kerem Yildirim
- Department of Orthopaedics and Traumatology, Beyzadeoglu Clinic, Istanbul, Turkey
| | - Tuna Pehlivanoglu
- School of Health Sciences, Yeni Yuzyil University, Istanbul, Turkey.,Department of Orthopaedics and Traumatology, Emsey Hospital, Istanbul, Turkey
| | - Reha N Tandogan
- Department of Orthopaedics and Traumatology, Emsey Hospital, Istanbul, Turkey.,Department of Orthopaedics and Traumatology, Ortoklinik and Cankaya Orthopedics, Ankara, Turkey
| | - Tahsin Beyzadeoglu
- Department of Orthopaedics and Traumatology, Beyzadeoglu Clinic, Istanbul, Turkey.,Faculty of Health Sciences, Halic University, Istanbul, Turkey
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Latif J, Aveledo R, Lam PH, Murrell GAC. Postoperative Pain and Paresthesia in Labral Repairs of the Shoulder: Location Does Matter. Orthop J Sports Med 2022; 10:23259671221105080. [PMID: 35747364 PMCID: PMC9210089 DOI: 10.1177/23259671221105080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Favorable outcomes have been reported regarding postoperative shoulder pain and function after repair of anteroinferior (Bankart) glenohumeral labral tears. However, the outcomes of patients after repair of isolated superior labral anterior-posterior (SLAP) tears are a contentious topic. The authors have also anecdotally noted that patients evaluated with labral tears complained of numbness and tingling in their ipsilateral hand. Purpose: To determine if there is a difference in the temporal outcomes of shoulder pain and hand paresthesia in patients with SLAP tears versus Bankart tears after arthroscopic repair. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 66 consecutive patients who underwent arthroscopic labral repair at a single institution between August 2018 and February 2021. The prevalence and magnitude of shoulder pain as well as numbness and tingling of the hand were assessed using questions from the L’Insalata Shoulder Questionnaire and the Boston Carpal Tunnel Questionnaire preoperatively and at 1 week, 6 weeks, 12 weeks, and 6 months after surgery. Results: Preoperatively, patients with SLAP lesions reported a higher prevalence of shoulder pain during sleep compared with those with Bankart tears (P < .05). Postoperatively, patients who underwent SLAP repair reported a larger proportion and more severe magnitude of shoulder pain during rest, overhead activities, and sleep compared with those who underwent Bankart repair (P < .05). Only patients who underwent Bankart repair reported improvements in the prevalence and magnitude of their shoulder pain during rest, overhead activities, and sleep by 6 months postoperatively compared with preoperative levels (P < .05). Preoperatively, 30% of patients with Bankart repairs and 40% of patients with SLAP repairs reported hand tingling, while 35% and 50%, respectively, reported hand numbness. The prevalence and magnitude of hand tingling and numbness were not significantly different between groups at any time point. Conclusion: Study results indicated that patients who underwent SLAP repair experienced worse shoulder pain outcomes compared with those who underwent Bankart repair using the same anchor and surgical technique. Only patients who underwent Bankart repair reported improvements in their hand numbness after surgery. Therefore, labral tear location does matter with respect to shoulder pain and hand numbness.
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Affiliation(s)
- Joseph Latif
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
| | - Ricardo Aveledo
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
| | - Patrick H Lam
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
| | - George A C Murrell
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
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Eren İ, Büyükdogan K, Yürük B, Aslan L, Birsel O, Demirhan M. Patients without re-dislocation in the short term after arthroscopic knotless Bankart repair for anterior shoulder instability may show residual apprehension and recurrence in the long term after 5 years. J Shoulder Elbow Surg 2022; 31:978-983. [PMID: 34871729 DOI: 10.1016/j.jse.2021.10.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/25/2021] [Accepted: 10/30/2021] [Indexed: 02/01/2023]
Abstract
HYPOTHESIS The aim of this study was to report the long-term results, residual instability, and recurrence rate of arthroscopic Bankart repair surgery without a re-dislocation event in the first 5 years. METHODS We performed a retrospective analysis of Bankart repairs performed in a single center, by a single surgeon, with a minimum of 5 years' follow-up. Patients without a re-dislocation in the first 5 years of surgery were included. Patients who underwent open repair, those who underwent revision surgery, and those with critical glenoid bone loss were excluded. A total of 68 shoulders in 66 patients (51 male and 15 female patients) were included. Patients were analyzed in 2 domains: (1) failures defined as re-dislocation and (2) failures defined as apprehension and re-dislocation combined (residual instability). Clinical outcomes were assessed using shoulder range of motion, the American Shoulder and Elbow Surgeons score, and the Western Ontario Shoulder Instability Index (WOSI) score. Pain, residual apprehension, re-dislocations, and additional surgical procedures were recorded. RESULTS The mean age of patients was 31.16 (range, 16-60 years), and the mean follow-up duration was 8.42 ± 2.1 years. The median number of dislocations was 3 (range, 1-20), and the median time from first dislocation to surgery was 16 months (interquartile range, 3-100.5 months). Five patients reported re-dislocations (7.4%) with a mean period of 6.54 ± 2.5 years (range, 5-10.8 years). Seven patients without re-dislocations and 2 patients with re-dislocations reported residual apprehension. Mean shoulder elevation and mean external rotation were 161.3° ± 12.4° and 39.2° ± 11°, respectively. The mean visual analog scale, American Shoulder and Elbow Surgeons, and WOSI scores were 0.5 ± 1.4, 91 ± 11.9, and 88 ± 12.1, respectively. Age was similar in patients with stable shoulders and those with shoulders with re-dislocation or residual instability. The WOSI score was lower in patients with re-dislocation and residual instability (P = .030 and P = .049, respectively). CONCLUSIONS Arthroscopic Bankart repair is a successful surgical option for anterior shoulder instability. The 7.4% re-dislocation rate after 5 years indicates there may be a deterioration of capsulolabral repair in certain patients. The long-term failure pattern may be underestimated in short- to mid-term projections.
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Affiliation(s)
- İlker Eren
- Department of Orthopaedics and Traumatology, School of Medicine, Koc University, Istanbul, Turkey.
| | - Kadir Büyükdogan
- Department of Orthopaedics and Traumatology, Koc University Hospital, Istanbul, Turkey
| | - Batuhan Yürük
- Department of Orthopaedics and Traumatology, School of Medicine, Koc University, Istanbul, Turkey
| | - Lercan Aslan
- Department of Orthopaedics and Traumatology, Koc University Hospital, Istanbul, Turkey
| | - Olgar Birsel
- Department of Orthopaedics and Traumatology, School of Medicine, Koc University, Istanbul, Turkey
| | - Mehmet Demirhan
- Department of Orthopaedics and Traumatology, School of Medicine, Koc University, Istanbul, Turkey
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Mu Z, Hua H, Dong X. Comparison of efficacy between montgomery and Jobe technique and arthroscopic bankart repair in treating traumatic recurrent anterior shoulder dislocation. Am J Transl Res 2021; 13:8505-8513. [PMID: 34377348 PMCID: PMC8340174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of Montgomery and Jobe technique versus arthroscopic Bankart repair in treating traumatic recurrent anterior shoulder dislocation (ASD). METHODS A total of 113 patients with traumatic recurrent ASD admitted to our hospital from June 2016 to January 2019 were selected as study subjects, and were divided into Group A and B in accordance with surgical options. The clinical data of the subjects were collected retrospectively. Group A was treated by the Montgomery and Jobe technique, while Group B was treated with arthroscopic Bankart repair. The arthroscopic manifestations were analyzed before and after arthroscopic Bankart repair. Scores of visual analogue scale (VAS) for shoulder joint and American Shoulder and Elbow Surgeons (ASES), Constant-Murley Score (CMS), Rowe Score, and complications were compared between the two groups before and after surgery. RESULTS Compared with Group A, Group B had a lower score of VAS for the shoulder joint, and higher scores of the range of motion (ROM), functional activities, myodynamia, pain, CMS, vital functions, ASES, and shoulder joint function, and a higher Rowe score after surgery (P < 0.05). The incidence rate (1.75%) of complications in Group B was lower than that (14.29%) in Group A (P < 0.05). CONCLUSION Arthroscopic Bankart repair is superior to the Montgomery and Jobe technique in treating traumatic recurrent ASD. Arthroscopic Bankart repair, exhibiting a high safety profile, is conducive to improving shoulder joint function and pain.
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Affiliation(s)
- Zhongjie Mu
- Department of Orthopaedic Surgery, Fuyang Orthopaedics and Traumatology Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 311400, Zhejiang, China
| | - Hui Hua
- Department of Orthopaedic Surgery, Fuyang Orthopaedics and Traumatology Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 311400, Zhejiang, China
| | - Xinhua Dong
- Department of Orthopaedic Surgery, Fuyang Orthopaedics and Traumatology Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 311400, Zhejiang, China
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Wu IT, Desai VS, Mangold DR, Camp CL, Barlow JD, Sanchez-Sotelo J, Dahm DL, Krych AJ. Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up. Knee Surg Sports Traumatol Arthrosc 2021; 29:2077-2084. [PMID: 32462270 DOI: 10.1007/s00167-020-06057-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/10/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare rates of recurrent instability, revision surgery and functional outcomes following arthroscopic anterior capsulolabral repair for recurrent anterior instability using knot-tying versus knotless suture anchor techniques. METHODS Patients who had undergone arthroscopic anterior labrum and capsular repair for recurrent anterior glenohumeral instability using knotless anchors were identified. Those with minimum 2-year follow-up were matched (1:2) to knot-tying anchor repair patients. Rates of failure and recurrent instability were compared, as well as Visual Analog Scale (VAS), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), University of California Los Angeles (UCLA) and Rowe scores. RESULTS One hundred and two patients (89 males, 13 females) with a mean age of 24.3 ± 9.6 were included. Repair was performed with knotless anchors in 34 and knot-tying anchors in 68 shoulders. At mean follow-up of 4.8 ± 2.5 years, re-dislocation rates between groups were not significantly different (knotless anchor: 9% versus knot-tying group: 15%, n.s.), but the knot-tying group showed a higher re-subluxation rate (p = 0.039). 12 (18%) revisions were performed in the knot-tying group at a mean 2.9 years after surgery and 1 (3%) revision in the knotless anchors group at 1.4 years (n.s.). There was no difference in mean VAS with use (1.3 ± 1.9 versus 0.8 ± 1.5, n.s.), SANE scores (91.8 ± 12.7 versus 92.0 ± 11.0, n.s.), QuickDASH scores (4.1 ± 5.5 versus 3.0 ± 6.5, n.s.), UCLA Shoulder Score (32.5 ± 3.6 versus 33.2 ± 3.1, n.s.), or Rowe scores (90.5 ± 18.5 versus 92.2 ± 16.6, n.s.) between knotless and knot-tying groups, respectively. VAS at rest was higher in the knotless group (0.7 ± 1.5 vs 0.1 ± 0.4, p = 0.021). CONCLUSIONS Knotless anchors demonstrated similar rates of re-dislocation and revision surgery, and lower rates of recurrent subluxation, compared to knot-tying anchors. Patients achieved good-to-excellent functional outcomes. This supports the efficacy of knotless anchors as an alternative to knot-tying anchors for arthroscopic anterior labral repair of recurrent anterior shoulder dislocation. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Isabella T Wu
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Vishal S Desai
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Devin R Mangold
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Christopher L Camp
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Jonathan D Barlow
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Joaquin Sanchez-Sotelo
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Diane L Dahm
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
| | - Aaron J Krych
- Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
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