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Abstract

Background

Although arthroscopic glenoid labrum repair using the BioKnotless anchor is common, the benefits and efficacy have not been fully evaluated.

Hypothesis

BioKnotless suture anchor is a clinically and radiologically suitable material for arthroscopic labral repair.

Study Design

Case series; Level of evidence, 4.

Methods

Ninety-seven patients underwent arthroscopic glenoid labrum repair with BioKnotless anchor between July 2004 and December 2005. Thirty-seven patients had traumatic anterior instability and 60 patients had an isolated superior labrum, anterior-posterior (SLAP) lesion. The mean age at surgery was 36.0 years (range, 15–66); the average follow-up was 34.1 months (range, 24–54). Clinical outcomes were evaluated using range of motion and various functional evaluation scores including sports activity. Pain and patient satisfaction were measured using a visual analog scale (VAS). Computed tomography arthrography was conducted in 73 patients at least 1 year after surgery for radiologic evaluation.

Results

In patients with instability, the Western Ontario Shoulder Instability index and Rowe score improved from 53.2 to 85.9 and from 68.7 to 92.7, respectively. Return to normal recreation and sports were possible in 30 patients (81.1%); the mean satisfaction VAS was 9.2. There was 1 postoperative dislocation, and the apprehension test was positive in 1 case. Postoperative range of motion including external rotation was not different. In patients with a SLAP lesion, the American Shoulder and Elbow Surgeons score and Constant score improved from 67.3 to 96.0 and 79.1 to 96.8, respectively. Pain VAS decreased from 6.0 to 0.4, and the mean satisfaction VAS was 9.4. Return to normal recreation and sports were possible in 50 patients (83.3%). All labra were found to have firmly healed to bony glenoid rim without anchor-related osteolysis in postoperative CT arthrography.

Conclusion

Clinically and radiologically, the BioKnotless anchor appears to be an acceptable alternative for arthroscopic labrum repair, and a suitable material allowing the avoidance of certain troublesome drawbacks of the conventional knot-tying suture anchor.

Keywords

Bioknotless suture anchor Bankart lesion superior labrum anterior-posterior (SLAP) lesion

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References

Antonogiannakis

Yiannakopoulos

Karliaftis

Karabalis

. Late disengagement of a knotless anchor. Arthroscopy. 2002;18(8):e40. Available at http://www.journals.elsevierhealth.com/periodicals/yjars/article/S0749-8063(02)70019-4/fulltext . Accessed August 12, 2009.

Athwal

Shridharani

O’Driscoll

. Osteolysis and arthropathy of the shoulder after use of bioabsorbable knotless suture anchors: a report of four cases. J Bone Joint Surg Am. 2006;88(8):1840–1845.

Barber

Snyder

Abrams

Fanelli

Savoie

3rd . Arthroscopic Bankart reconstruction with a bioabsorbable anchor. J Shoulder Elbow Surg. 2003;12(6):535–538.

Bitzer

Nasko

Krackhardt

. Direct CT-arthrography versus direct MR-arthrography in chronic shoulder instability: comparison of modalities after the introduction of multidetector-CT technology [in German]. Rofo. 2004;176(12):1770–1775.

Carreira

Mazzocca

Oryhon

Brown

Hayden

Romeo

. A prospective outcome evaluation of arthroscopic Bankart repairs: minimum 2-year follow-up. Am J Sports Med. 2006;34(5):771–777.

Cho

Lubis

Rhee

. Clinical results of arthroscopic Bankart repair with knot-tying and knotless suture anchors. Arthroscopy. 2006;22(12):1276–1282.

Garofalo

Mocci

Moretti

. Arthroscopic treatment of anterior shoulder instability using knotless suture anchors. Arthroscopy. 2005;21(11):1283–1289.

Gartsman

Roddey

Hammerman

. Arthroscopic treatment of anterior-inferior glenohumeral instability: two to five-year follow-up. J Bone Joint Surg Am. 2000;82(7):991–1003.

Hayashida

Yoneda

Mizuno

Fukushima

Nakagawa

. Arthroscopic Bankart repair with knotless suture anchor for traumatic anterior shoulder instability: results of short-term follow-up. Arthroscopy. 2006;22(6):620–626.

10.

Holtby

Razmjou

. Accuracy of the Speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. Arthroscopy. 2004;20(3):231–236.

11.

Kim

Cho

Ryu

. Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. J Bone Joint Surg Am. 2003;85(8):1511–1518.

12.

Kim

Queale

Cosgarea

McFarland

. Clinical features of the different types of SLAP lesions: an analysis of one hundred and thirty-nine cases. J Bone Joint Surg Am. 2003;85(1):66–71.

13.

Leedle

Miller

. Pullout strength of knotless suture anchors. Arthroscopy. 2005;21(1):81–85.

14.

Marquardt

Witt

Gotze

Liem

Steinbeck

Potzl

. Long-term results of arthroscopic Bankart repair with a bioabsorbable tack. Am J Sports Med. 2006;34(12):1906–1910.

15.

Marquardt

Witt

Liem

Steinbeck

Potzl

. Arthroscopic Bankart repair in traumatic anterior shoulder instability using a suture anchor technique. Arthroscopy. 2006;22(9):931–936.

16.

McFarland

Kim

Savino

. Clinical assessment of three common tests for superior labral anterior-posterior lesions. Am J Sports Med. 2002;30(6):810–815.

17.

O’Brien

Allen

Coleman

Drakos

. 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. 2002;18(4):372–377.

18.

Rhee

. Knot-induced glenoid erosion after arthroscopic fixation for unstable superior labrum anterior-posterior lesion: case report. J Shoulder Elbow Surg. 2006;15(3):391–393.

19.

Sugimoto

Suzuki

Mihara

Kubota

Tsutsui

. MR arthrography of shoulders after suture-anchor Bankart repair. Radiology. 2002;224(1):105–111.

20.

Take

Yoneda

Hayashida

Nakagawa

Mizuno

. Enlargement of drill holes after use of a biodegradable suture anchor: quantitative study on consecutive postoperative radiographs. Arthroscopy. 2008;24(3):251–257.

21.

Tan

Guisasola

Machani

. Arthroscopic stabilization of the shoulder: a prospective randomized study of absorbable versus non-absorbable suture anchors. Arthroscopy. 2006;22(7):716–720.

22.

Thal

. Arthroscopic Bankart repair using knotless suture anchors. Arthroscopy. 2007;23(5):566–568.

23.

Thal

. A knotless suture anchor: design, function, and biomechanical testing. Am J Sports Med. 2001;29(5):646–649.

24.

Thal

. Knotless suture anchor: arthroscopic Bankart repair without tying knots. Clin Orthop Relat Res. 2001;390:42–51.

25.

Thal

. A Knotless suture anchor: technique for use in arthroscopic Bankart repair. Arthroscopy. 2001;17(2):213–218.

26.

Thal

Nofziger

Bridges

Kim

. Arthroscopic Bankart repair using Knotless or BioKnotless suture anchors: 2- to 7-year results. Arthroscopy. 2007;23(4):367–375.

27.

Wagner

Schweitzer

Morrison

Fenlin

Jr Bartolozzi

. Shoulder instability: accuracy of MR imaging performed after surgery in depicting recurrent injury—initial findings. Radiology. 2002;222(1):196–203.

28.

Weiler

Hoffmann

Stahelin

Helling

Sudkamp

. Biodegradable implants in sports medicine: the biological base. Arthroscopy. 2000;16(3):305–321.

29.

Zumstein

Jacob

Schneeberger

. In vitro comparison of standard and Knotless metal suture anchors. Arthroscopy. 2004;20(5):517–520.

Clinical and Radiologic Outcomes of Arthroscopic Glenoid Labrum Repair With the BioKnotless Suture Anchor

Abstract

Background

Hypothesis

Study Design

Methods

Results

Conclusion

Keywords

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References