Abstract
The purpose of the study was to evaluate the functional outcome and recurrent dislocation rate in patients who have undergone arthroscopic shoulder stabilization with a bioabsorbable fixation device, Suretac (Acufex Microsurgical). The role of thermal capsular shrinkage was also investigated.
Between June 1996 and June 2000, 78 consecutive patients (80 shoulders) at our hospital underwent arthroscopic stabilization with Suretac fixator by our senior author (DM). Twenty-one performed for acute post-traumatic dislocation (defined as first time dislocation), 41 for recurrent dislocations, 14 for SLAP lesions and four atraumatic multidirectional instability. Patients were followed up by an independent observer (FL) after a mean of 35 months (range: 9–62 months). The follow up examination included the modified Rowe and Zarins score, the American Shoulder and Elbow Surgeons score and the Constant score. The strength of lateral elevation as advocated in the Constant score was measured by the Nottingham Mecmesin Myometer.
The overall re-dislocation rate after surgery was 14% (11 patients). This occurred after an average period of 23 months (range: 12–37 months) following the initial stabilization procedure. One patient also reported recurrent subluxation though without frank dislocation. The re-dislocation for patients with acute dislocation was 9%, 15% for recurrent dislocation, 14% for SLAP lesions and 25% for those with atraumatic multidirectional instability. 3 of the 19 patients who underwent arthroscopic stabilization and thermal capsular shrinkage also re-dislocated. Four of the 10 patients who were aged 18 or under at the time of surgery, re-dislocated after an average period of 18 months following the operation.
Our study shows that the functional outcome and recurrence rate of Suretac stabilization compare favorably to other arthroscopic repair techniques using nonabsorbable suture anchors. The results appear to be better in patients with acute post traumatic dislocation. We do not recommend its use in younger patients (18 or under) especially with multidirectional instability. There is not enough evidence in our study to support the theoretical benefits of thermal capsular shrinkage.
The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN
