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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

18.05.2020 | SHOULDER

Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up

verfasst von: Isabella T. Wu, Vishal S. Desai, Devin R. Mangold, Christopher L. Camp, Jonathan D. Barlow, MD, MS, Joaquin Sanchez-Sotelo, Diane L. Dahm, Aaron J. Krych

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2021

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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.

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Titel: Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up
verfasst von: Isabella T. Wu
Vishal S. Desai
Devin R. Mangold
Christopher L. Camp
Jonathan D. Barlow, MD, MS
Joaquin Sanchez-Sotelo
Diane L. Dahm
Aaron J. Krych
Publikationsdatum: 18.05.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2021
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-06057-7

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Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up