Clinical Results Of a Modified Arthroscopic Transosseous All-Suture Anchor Technique in Anterior Instability Repair Of The Shoulder
Author(s):
Aboalata M. (Egypt)
Aboalata M. (Egypt)
Affiliations:
ESSKA Academy. Aboalata M. 05/09/18; 209855; P21-1667 Topic: D1 - Arthroscopic anterior repair (labrum, capsule)
Dr. Mohamed Aboalata
Dr. Mohamed Aboalata
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Abstract
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Objectives: Evaluation of the results of a newly proposed technique to improve fixation strength of the arthroscopic Bankart repair using a modified arthroscopic all-suture anchor technique in anterior shoulder instability repair.

Methods: Patients who underwent a modified arthroscopic procedure for repair of anterior shoulder instability were recruited at a minimum of two years after surgery. The technique is performed utilizing a special configuration of strong non-absorbable #2 polyethylene/ polyester suture passed through Suture tape loaded on a special inserter and inserted trans-osseous through the glenoid from anterior to posterior. The resultant duplicated knot rests on the posterior glenoid cortex yielding an anchor with sliding sutures used for fixation of the capsulolabral complex at the three standard points (5.30, 4 and 3 o'clock positions).
Patients were evaluated with the VAS for pain and instability, ASES, ROWE, Constant scores. Factors that may affect the results were recorded (number and type of the fixation devices, number of preoperative dislocations, concomitant lesions, age at the time of dislocation and operation, time interval between the first dislocation and operation). Descriptive statistical analysis was used to compare pre- and postoperative results.

Results: 14 patients were available for follow-up after at a minimum of two years. The mean follow up duration was 25.8 months. There was a significant improvement of the various clinical scores used (ASES: 94.2, ROWE: 93.9, Constant: 95.6 (P< 0.05). None of the patients reported any redislocation. Subjective apprehension was reported by only two patient (10%). No patients had persistent postoperative instability requiring revision. The average VAS for pain was 0.65 and for instability 0.8 with a median external rotation deficit of 5°. All patients were satisfied with the results of the procedure. Age of the patients was the only factor significantly associated with higher VAS for subjective postoperative instability and pain.

Conclusions: The results of modified arthroscopic transosseous all-suture anchor technique shows promising clinical results without added complications and offers a cheap and easy reproducible alternative in developing countries. Additionally the strength of fixation resting on the posterior glenoid cortex is not clinically inferior, even may be superior to the standard used suture anchors. Longer-term follow-up studies as well as biomechanical studies are needed to support the clinical data obtained.

Keywords:
shoulder instability, transosseous bankart repair, open Bankart repair
Objectives: Evaluation of the results of a newly proposed technique to improve fixation strength of the arthroscopic Bankart repair using a modified arthroscopic all-suture anchor technique in anterior shoulder instability repair.

Methods: Patients who underwent a modified arthroscopic procedure for repair of anterior shoulder instability were recruited at a minimum of two years after surgery. The technique is performed utilizing a special configuration of strong non-absorbable #2 polyethylene/ polyester suture passed through Suture tape loaded on a special inserter and inserted trans-osseous through the glenoid from anterior to posterior. The resultant duplicated knot rests on the posterior glenoid cortex yielding an anchor with sliding sutures used for fixation of the capsulolabral complex at the three standard points (5.30, 4 and 3 o'clock positions).
Patients were evaluated with the VAS for pain and instability, ASES, ROWE, Constant scores. Factors that may affect the results were recorded (number and type of the fixation devices, number of preoperative dislocations, concomitant lesions, age at the time of dislocation and operation, time interval between the first dislocation and operation). Descriptive statistical analysis was used to compare pre- and postoperative results.

Results: 14 patients were available for follow-up after at a minimum of two years. The mean follow up duration was 25.8 months. There was a significant improvement of the various clinical scores used (ASES: 94.2, ROWE: 93.9, Constant: 95.6 (P< 0.05). None of the patients reported any redislocation. Subjective apprehension was reported by only two patient (10%). No patients had persistent postoperative instability requiring revision. The average VAS for pain was 0.65 and for instability 0.8 with a median external rotation deficit of 5°. All patients were satisfied with the results of the procedure. Age of the patients was the only factor significantly associated with higher VAS for subjective postoperative instability and pain.

Conclusions: The results of modified arthroscopic transosseous all-suture anchor technique shows promising clinical results without added complications and offers a cheap and easy reproducible alternative in developing countries. Additionally the strength of fixation resting on the posterior glenoid cortex is not clinically inferior, even may be superior to the standard used suture anchors. Longer-term follow-up studies as well as biomechanical studies are needed to support the clinical data obtained.

Keywords:
shoulder instability, transosseous bankart repair, open Bankart repair
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