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Erschienen in: Archives of Orthopaedic and Trauma Surgery 9/2018

22.05.2018 | Arthroscopy and Sports Medicine

Outcome of arthroscopic SLAP repair using knot-tying-suture anchors compared with knotless-suture anchors in athletes

verfasst von: Y. Reinig, F. Welsch, R. Hoffmann, D. Müller, K. F. Schüttler, E. Zimmermann, Thomas Stein

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 9/2018

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Abstract

Introduction

Arthroscopic repair is one option for the surgical treatment of type II superior labrum tears from anterior to posterior (SLAP) lesions in athletes’ shoulders.

Materials and methods

Sixty-one of 78 (78.2%) athletes were retrospectively examined after isolated arthroscopic SLAP repair (group 1/G1: 28x knot-tying anchors; group 2/G2: 33 knotless anchors; follow-up 24 months) and compared to two specific, separate matched volunteer athlete control groups (group 3/G3: 28 athletes matched to G1; group 4/G4: 33 athletes matched to G2). The assessment of G1–4 included numerical analogue scales (NASs: 1–15 scales) and the Athletic Shoulder Outcome Scoring System (ASOSS) score, and the Shoulder Sport Activity Score (SSAS). The preinjury status (FU-1), the status before surgery (FU0), and at follow-up (FU1) were assessed.

Results

High external rotation at abduction (hER) was significantly worse in G1 than G2 (FU1: G1, 86.6° ± 7.7° versus = vs G2, 91.1° ± 10.7°; p = 0.03). The ASOSS and SSAS revealed significant impairment in G1–2 compared to G3–4 (ASOSS FU1: 83.9 ± 19.9 G1 vs 94.6 ± 7.7 G3; p = 0.002 and 80.3 ± 17.7 G2 vs 91.8 ± 9.1 G4; p = 0.002; SSAS 5.9 ± 2.7 G1 vs 6.9 ± 1.8 G3; p = 0.02 and 6.3 ± 2.5 G2 vs 7.4 ± 1.4 G4; p = 0.06), with 17–20% loss on ASOSS and 23–25% deficits on SSAS. The NAS analysis detected for pain (4 ± 3.5 vs 3.2 ± 2.6), satisfaction (2 ± 0.8 vs 1.8 ± 0.9), reduction of function (4.6 ± 3.9 vs 3.9 ± 3.8) and proficiency (9.6 ± 4.7 vs 10.9 ± 3.9) similar impairments in G1–2 (p > 0.05) and better results in G3 and G4 (all p < 0.001).

Conclusions

After SLAP repair, athletes showed underestimated impairment of shoulder sport resumption and proficiency with high rates of shoulder sports cessation. The present data favor the knotless fixation technique, because this fixation technique allowed bilaterally equivalent ranges of motions. The uninjured shoulder athletes also showed functional deficits with significant shoulder sport impairments, which must be considered in outcome analysis and for the rehabilitation program.

Level of evidence

III, retrospective cohort study.
Literatur
1.
Zurück zum Zitat Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13(5):337–341PubMedCrossRef Andrews JR, Carson WG Jr, McLeod WD (1985) Glenoid labrum tears related to the long head of the biceps. Am J Sports Med 13(5):337–341PubMedCrossRef
2.
Zurück zum Zitat Snyder SJ, Banas MP, Karzel RP (1995) An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg 4(4):243–248PubMedCrossRef Snyder SJ, Banas MP, Karzel RP (1995) An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elbow Surg 4(4):243–248PubMedCrossRef
3.
Zurück zum Zitat Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology. Part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy 19(5):531–539PubMedCrossRef Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology. Part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy 19(5):531–539PubMedCrossRef
9.
13.
Zurück zum Zitat Soldatis JJ, Moseley JB, Etminan M (1997) Shoulder symptoms in healthy athletes: a comparison of outcome scoring systems. J Shoulder Elbow Surg 6(3):265–271PubMedCrossRef Soldatis JJ, Moseley JB, Etminan M (1997) Shoulder symptoms in healthy athletes: a comparison of outcome scoring systems. J Shoulder Elbow Surg 6(3):265–271PubMedCrossRef
15.
Zurück zum Zitat Vangsness CT Jr, Jorgenson SS, Watson T, Johnson DL (1994) The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br 76(6):951–954PubMedCrossRef Vangsness CT Jr, Jorgenson SS, Watson T, Johnson DL (1994) The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br 76(6):951–954PubMedCrossRef
16.
Zurück zum Zitat Chokshi BV, Kubiak EN, Jazrawi LM, Ticker JB, Zheng N, Kummer FJ, Rokito AS (2006) The effect of arthroscopic suture passing instruments on rotator cuff damage and repair strength. Bull Hosp Jt Dis 63(3–4):123–125PubMed Chokshi BV, Kubiak EN, Jazrawi LM, Ticker JB, Zheng N, Kummer FJ, Rokito AS (2006) The effect of arthroscopic suture passing instruments on rotator cuff damage and repair strength. Bull Hosp Jt Dis 63(3–4):123–125PubMed
17.
Zurück zum Zitat Allain J, Goutallier D, Glorion C (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80(6):841–852PubMedCrossRef Allain J, Goutallier D, Glorion C (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80(6):841–852PubMedCrossRef
18.
Zurück zum Zitat Tibone JE, Bradley J (1993) Evaluation of treatment outcomes for the athletes shoulder. The shoulder: a balance of mobility and stability. The American Academy of Othropaedic Surgeons, Rosemont Tibone JE, Bradley J (1993) Evaluation of treatment outcomes for the athletes shoulder. The shoulder: a balance of mobility and stability. The American Academy of Othropaedic Surgeons, Rosemont
19.
Zurück zum Zitat Zeichen J, Meller R, Siegel A, Gehrke A, Hecker H, Krettek C (2004) Is the shoulder sport activity after shoulder injuries quantifiable? Implementation of a new Shoulder Sport Activity Score. German Congress for Orthopaedics and Traumatology, Berlin, Zeichen J, Meller R, Siegel A, Gehrke A, Hecker H, Krettek C (2004) Is the shoulder sport activity after shoulder injuries quantifiable? Implementation of a new Shoulder Sport Activity Score. German Congress for Orthopaedics and Traumatology, Berlin,
21.
Zurück zum Zitat Walch G (1987) Walch-Duplay rating sheet for anterior instability of the shoulder. Paper presented at the SESEC/ESSE, Paris Walch G (1987) Walch-Duplay rating sheet for anterior instability of the shoulder. Paper presented at the SESEC/ESSE, Paris
28.
Zurück zum Zitat O’Brien SJ, Allen AA, Coleman SH, Drakos MC (2002) The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy 18(4):372–377PubMedCrossRef O’Brien SJ, Allen AA, Coleman SH, Drakos MC (2002) The trans-rotator cuff approach to SLAP lesions: technical aspects for repair and a clinical follow-up of 31 patients at a minimum of 2 years. Arthroscopy 18(4):372–377PubMedCrossRef
29.
Zurück zum Zitat Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14(6):553–565PubMedCrossRef Morgan CD, Burkhart SS, Palmeri M, Gillespie M (1998) Type II SLAP lesions: three subtypes and their relationships to superior instability and rotator cuff tears. Arthroscopy 14(6):553–565PubMedCrossRef
33.
Zurück zum Zitat Kim SH, Ha KI, Kim SH, Choi HJ (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A(6):981–985PubMedCrossRef Kim SH, Ha KI, Kim SH, Choi HJ (2002) Results of arthroscopic treatment of superior labral lesions. J Bone Joint Surg Am 84-A(6):981–985PubMedCrossRef
36.
37.
Zurück zum Zitat Yoneda M, Hirooka A, Saito S, Yamamoto T, Ochi T, Shino K (1991) Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br 73(5):746–750PubMedCrossRef Yoneda M, Hirooka A, Saito S, Yamamoto T, Ochi T, Shino K (1991) Arthroscopic stapling for detached superior glenoid labrum. J Bone Joint Surg Br 73(5):746–750PubMedCrossRef
40.
Zurück zum Zitat Baltaci G, Johnson R, Kohl H III (2001) Shoulder range of motion characteristics in collegiate baseball players. J Sports Med Phys Fit 41(2):236–242 Baltaci G, Johnson R, Kohl H III (2001) Shoulder range of motion characteristics in collegiate baseball players. J Sports Med Phys Fit 41(2):236–242
41.
Zurück zum Zitat Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ (1997) Shoulder motion and laxity in the professional baseball player. Am J Sports Med 25(5):609–613PubMedCrossRef Bigliani LU, Codd TP, Connor PM, Levine WN, Littlefield MA, Hershon SJ (1997) Shoulder motion and laxity in the professional baseball player. Am J Sports Med 25(5):609–613PubMedCrossRef
43.
Zurück zum Zitat Ide J, Maeda S, Takagi K (2004) Arthroscopic Bankart repair using suture anchors in athletes: patient selection and postoperative sports activity. Am J Sports Med 32(8):1899–1905PubMedCrossRef Ide J, Maeda S, Takagi K (2004) Arthroscopic Bankart repair using suture anchors in athletes: patient selection and postoperative sports activity. Am J Sports Med 32(8):1899–1905PubMedCrossRef
44.
Zurück zum Zitat Lephart SM, Henry TJ (1995) Functional rehabilitation for the upper and lower extremity. Orthop Clin North Am 26(3):579–592PubMed Lephart SM, Henry TJ (1995) Functional rehabilitation for the upper and lower extremity. Orthop Clin North Am 26(3):579–592PubMed
45.
Zurück zum Zitat Myers JB, Lephart SM (2000) The role of the sensorimotor system in the athletic shoulder. J Athl Train 35(3):351–363PubMedPubMedCentral Myers JB, Lephart SM (2000) The role of the sensorimotor system in the athletic shoulder. J Athl Train 35(3):351–363PubMedPubMedCentral
46.
Zurück zum Zitat Myers JB, Lephart SM (2002) Sensorimotor deficits contributing to glenohumeral instability. Clin Orthop Relat Res 400:98–104CrossRef Myers JB, Lephart SM (2002) Sensorimotor deficits contributing to glenohumeral instability. Clin Orthop Relat Res 400:98–104CrossRef
47.
Zurück zum Zitat Myers JB, Wassinger CA, Lephart SM (2006) Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther 11(3):197–201PubMedCrossRef Myers JB, Wassinger CA, Lephart SM (2006) Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther 11(3):197–201PubMedCrossRef
48.
Zurück zum Zitat Swanik CB, Lephart SM, Rubash HE (2004) Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am 86-A(2):328–334PubMedCrossRef Swanik CB, Lephart SM, Rubash HE (2004) Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am 86-A(2):328–334PubMedCrossRef
49.
Zurück zum Zitat Warner JJ, Lephart S, Fu FH (1996) Role of proprioception in pathoetiology of shoulder instability. Clin Orthop Relat Res 330:35–39 Warner JJ, Lephart S, Fu FH (1996) Role of proprioception in pathoetiology of shoulder instability. Clin Orthop Relat Res 330:35–39
50.
Zurück zum Zitat Matsen FA, Lippit SB, Sidles JA, Harryman DT (1994) Practical evaluation and management of the shoulder. Saunders, Philadelphia Matsen FA, Lippit SB, Sidles JA, Harryman DT (1994) Practical evaluation and management of the shoulder. Saunders, Philadelphia
54.
Zurück zum Zitat Burkhart SS, Morgan CD (1998) The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy 14(6):637–640PubMedCrossRef Burkhart SS, Morgan CD (1998) The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy 14(6):637–640PubMedCrossRef
55.
Zurück zum Zitat Walch G, Liotard JP, Boileau P, Noel E (1993) Postero-superior glenoid impingement. Another impingement of the shoulder. J Radiol 74(1):47–50PubMed Walch G, Liotard JP, Boileau P, Noel E (1993) Postero-superior glenoid impingement. Another impingement of the shoulder. J Radiol 74(1):47–50PubMed
56.
Zurück zum Zitat Jobe CM (1995) Posterior superior glenoid impingement: expanded spectrum. Arthroscopy 11(5):530–536PubMedCrossRef Jobe CM (1995) Posterior superior glenoid impingement: expanded spectrum. Arthroscopy 11(5):530–536PubMedCrossRef
57.
Zurück zum Zitat Kibler WB (1998) The role of the scapula in athletic shoulder function. Am J Sports Med 26(2):325–337PubMedCrossRef Kibler WB (1998) The role of the scapula in athletic shoulder function. Am J Sports Med 26(2):325–337PubMedCrossRef
58.
Zurück zum Zitat Kibler WB, McMullen J (2003) Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg 11(2):142–151PubMedCrossRef Kibler WB, McMullen J (2003) Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg 11(2):142–151PubMedCrossRef
61.
Zurück zum Zitat Lippitt S, Matsen F (1993) Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res (291):20–28 Lippitt S, Matsen F (1993) Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res (291):20–28
62.
Zurück zum Zitat FA M (1994) Stability in “Practical evaluation and management of the shoulder”. Saunders FA M (1994) Stability in “Practical evaluation and management of the shoulder”. Saunders
Metadaten
Titel
Outcome of arthroscopic SLAP repair using knot-tying-suture anchors compared with knotless-suture anchors in athletes
verfasst von
Y. Reinig
F. Welsch
R. Hoffmann
D. Müller
K. F. Schüttler
E. Zimmermann
Thomas Stein
Publikationsdatum
22.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 9/2018
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-2951-8

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