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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http://dx.doi.org/10.1007/s00167-020-06057-7 | DOI Listing |
J Clin Orthop Trauma
February 2025
Utah Valley Orthopedics and Sports Medicine, 1157 N 300 W, Provo, UT, 84604, USA.
Purpose: To review outcomes of medial patellofemoral ligament reconstruction (MPFLR) using synthetic suture tape in biomechanical and clinical studies.
Methods: A comprehensive literature search was performed in three databases. Studies reporting biomechanical and/or clinical outcomes of MPFLR using synthetic suture tape were included.
BMC Surg
January 2025
Department of Obstetrics and Gynaecology, Krankenhaus Sachsenhausen, Frankfurt Am Main, Germany.
Background: Total laparoscopic hysterectomy (TLH) is nowadays the standard to treat benign and malignant disease occurring in the uterus, but the number of robotic-assisted surgeries is increasing worldwide. To facilitate the handling of sutures in a bi- and tri-dimensional plane, a new type of suture material has been developed, named barbed sutures, which are in use in different indications. In comparison to conventional suture materials, the barbs anchor the suture in the tissue, provide tissue approximation and prevent slippage without the need for knot tying.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Background: Arthroscopic labral repair of the hip is successfully performed with increasing frequency using either knotless or knotted suture anchors, each with its own risks and benefits.
Purpose: To examine biomechanical and clinical outcomes for labral repair of the hip based on the use of knotted or knotless suture anchors.
Study Design: Systematic review; Level of evidence, 4.
Arthrosc Tech
December 2024
Queensland Unit for Advanced Shoulder Research (QUASR), Queensland University of Technology, Brisbane, Australia.
Tenodesis of the long head of biceps is a common shoulder surgical procedure. Tenodesis can be performed either arthroscopically or open and within the glenohumeral joint, within the bicipital groove, or below the pectoralis major tendon insertion. Arthroscopic tenodesis of the biceps tendon reduces the risk of infection.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Orlin & Cohen Orthopedic Group, Smithtown, New York, U.S.A.
Direct repair of ulnar collateral ligament (UCL) injuries with suture augmentation has been successful in properly selected patients lacking chronic attritional wear of the medial elbow. Described is a Speed-Fix technique for direct UCL repair using SutureTape, with Brace augmentation. The Speed-Fix repair technique uses an inverted mattress knotless repair with a knotless SwiveLock anchor and FiberTape suture, which allows for theoretical compression at the repair site.
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