Purpose: This study was performed to evaluate the results of arthroscopic Bankart repair,
by use of Knotless or BioKnotless suture anchors (DePuy Mitek, Raynham, MA), for traumatic
anterior shoulder instability. Methods: We performed a retrospective evaluation of 73 consecutive patients with traumatic
anterior instability of the shoulder treated with arthroscopic Bankart repair by use
of metallic Knotless or BioKnotless suture anchors. No additional capsular plication,
thermal modification, or interval closure was performed in any patient. The senior
author performed all procedures. Independent examiners performed physical examinations.
Self-assessment questionnaire evaluations were completed, and preoperative and postoperative
American Shoulder and Elbow Surgeons and Rowe scores are reported. Results: Results at a minimum of 2 years’ follow-up (range, 2 to 7 years) are reported for
72 patients (57 male and 15 female patients) available for follow-up evaluation. One
patient was lost to follow-up. Of the patients, 5 (6.9%) had post-repair instability
(3 dislocations and 2 subluxations). The mean postoperative loss of external rotation,
at 90° of abduction, was 1°. All patients who had postoperative instability were aged
22 years or younger. The post-repair instability rate in this age group was 13.5%
(5/37). No failures occurred in patients aged over 22 years. Of the post-repair dislocations,
3 (7.5%) were in patients involved in contact or collision sports. All 5 failures
occurred early, within 2 years of the index surgery. Revision arthroscopic repairs
via Knotless or BioKnotless suture anchors were performed in 3 of 4 patients, and
a Latarjet procedure was also performed in the fourth patient. The fifth patient refused
further intervention. All of the revision shoulders remained stable at the latest
follow-up, 3 of which had at least 2 years of follow-up. Conclusions: Arthroscopic Bankart repair via Knotless or BioKnotless suture anchors showed a recurrence
rate of 6.9%. Using Knotless or BioKnotless suture anchors provides satisfactory results
with a low recurrence rate, minimal loss of motion, and reliable functional return,
even in contact and collision athletes. Level of Evidence: Level IV, therapeutic case series.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The pathology and treatment of recurrent dislocation of the shoulder joint.Br J Surg. 1939; 26: 23-29
- Uber operationen bei habitueller schulterluxation.Dtsch Ztschr Chir. 1906; 85: 199-222
- T-plasty modification of the Bankart procedure for multidirectional instability of the anterior and inferior types.J Bone Joint Surg Am. 1991; 73: 105-112
- Recurrent anterior dislocation of the shoulder: Results after the Bankart and Putti-Platt operations.J Bone Joint Surg Am. 1979; 61: 566-569
- Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports.Am J Sports Med. 1991; 19: 428-434
- Bankart repair in traumatic anterior shoulder instability: Open versus arthroscopic technique.Arthroscopy. 2002; 18: 755-763
- Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder: A preliminary report.J Bone Joint Surg Am. 1980; 62: 897-908
- Recurrent transient subluxation of the shoulder.J Bone Joint Surg Am. 1981; 63: 863-872
- The Bankart procedure: A long-term end-result study.J Bone Joint Surg Am. 1978; 60: 1-16
- An approach to the repair of avulsion of the glenohumeral ligaments: The management of traumatic anterior glenohumeral instability.J Bone Joint Surg Am. 1989; 71: 506-513
- Use of the suture anchor in open Bankart reconstruction: A follow-up report.Am J Sports Med. 1994; 22: 723-726
- Modification of the Bankart reconstruction with a suture anchor: Report of a new technique.Am J Sports Med. 1991; 19: 343-346
- Arthroscopic Bankart repair using suture anchors.Oper Tech Orthop. 1991; 1: 184-191
- Arthroscopic versus open Bankart procedures: A comparison of early morbidity and complications.Arthroplasty. 1993; 9: 371-374
- Arthroscopic Bankart suture repair.Am J Sports Med. 1993; 21: 348-353
- Arthroscopic shoulder stabilization using transglenoid sutures.Am J Sports Med. 1996; 24: 459-467
- Arthroscopic transglenoid multiple suture repair: 2 to 8 year results in 150 shoulders.Arthroscopy. 1997; 13: 609-619
- Arthroscopic repair of glenolabral injuries with an absorbable fixation device.J Shoulder Elbow Surg. 1997; 6: 383-392
- Arthroscopic bioabsorbable tack stabilization of initial anterior shoulder dislocations: A preliminary report.Arthroscopy. 1995; 11: 410-417
- Arthroscopic Bankart repair in a high demand patient population.Arthroscopy. 1997; 13: 51-60
- Arthroscopic Bankart procedure by suture technique: Indications, technique, and results.Arthroscopy. 1992; 8: 111-115
- Arthroscopic reconstruction for anterior shoulder instability.Tech Orthop. 1988; 3: 59-66
- Arthroscopic reconstruction of anterior shoulder instability. 1989 (Presented at the 4th International Conference on Surgery of the Shoulder, New York, NY)
- Shoulder arthroscopy: A review of the present state of the art.Contemp Orthop. 1982; 4: 523-531
- Arthroscopic staple capsulorrhaphy for anterior shoulder instability.Am J Sports Med. 1992; 20: 253-256
- Arthroscopic shoulder capsulorrhaphy using metal staples.Orthop Clin North Am. 1993; 24: 71-88
- Arthroscopic stapling repair for shoulder instability: A retrospective study of 50 cases.Arthroscopy. 1989; 5: 122-128
- Arthroscopy of the shoulder.Orthop Clin North Am. 1980; 11: 197-204
- Arthroscopic staple capsulorrhaphy: A long-term follow-up.Arthroscopy. 1993; 9: 190-194
- Arthroscopic staple capsulorrhaphy for recurrent anterior shoulder instability.Arthroscopy. 1988; 4: 106-111
- Arthroscopic Bankart suture repair: Technique and early results.Arthroscopy. 1987; 3: 111-122
- Arthroscopic transglenoid Bankart suture repair.Oper Tech Orthop. 1991; 1: 171-179
- Arthroscopic anterior shoulder stabilization: 2-5 year follow-up using a bioabsorbable tac. 1994 (Presented at the 10th Open Meeting of the American Shoulder and Elbow Surgeons, New Orleans, LA)
- An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack.J Bone Joint Surg Am. 1996; 78: 1801-1807
- Arthroscopic Bankart repair with the Suretac device.Arthroscopy. 1995; 11: 2-13
- Arthroscopic Bankart repair with the Suretac device.Arthroscopy. 1995; 11: 14-20
- Arthroscopic Bankart repair utilizing a cannulated absorbable fixation device.Orthop Trans. 1991; 15: 761-762
- Arthroscopic treatment of anterior-inferior glenohumeral instability.J Bone Joint Surg Am. 2000; 82: 991-1003
- Arthroscopic anterior shoulder capsulorrhaphy.Tech Orthop. 1988; 3: 67-73
- Arthroscopic anterior stabilization of the shoulder: Two to six-year follow-up.J Bone Joint Surg Am. 2003; 85: 1511-1518
- Arthroscopic anterior shoulder stabilization of collision and contact athletes.Am J Sports Med. 2003; 33: 52-60
- Arthroscopic inferior capsular slit and advancement for anterior and inferior shoulder instability: Technique and results at 2- to 5-year follow-up.Arthroscopy. 2000; 16: 451-456
- The kinematics and kinetics of slipknots for arthroscopic Bankart repair.Am J Sports Med. 2001; 29: 738-745
- Optimizing arthroscopic knots.Arthroscopy. 1995; 11: 199-206
- A knotless suture anchor.Am J Sports Med. 2001; 29: 646-649
- A knotless suture anchor: Technique for use in arthroscopic Bankart repair.Arthroscopy. 2001; 17: 213-218
- A standardized method for the assessment of shoulder function.J Shoulder Elbow Surg. 1994; 3: 347-352
- Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.Arthroscopy. 2000; 16: 677-694
- Technique in capsulorrhaphy (Caspari Technique).in: Parisien J.S. Current Techniques in Arthroscopy. Current Medicine, Philadelphia1996
- Arthroscopic treatment of anterior shoulder instability using knotless suture anchors.Arthroscopy. 2005; 21: 1283-1289
- Arthroscopic Bankart repair with knotless suture anchor for traumatic anterior shoulder instability: Results of short-term follow-up.Arthroscopy. 2006; 22: 620-626
- Clinical results of arthroscopic Bankart repair with knot-tying and knotless suture anchors.Arthroscopy. 2006; 22: 1276-1282
Article info
Footnotes
The other authors report no conflict of interest.
Identification
Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
