ARTHROSCOPIC CAPUSULOLABRAL RECONSTRUCTION USING THE KNOTLESS SUTURE ANCHOR – A TWO-YEAR FOLLOW-UP

Abstract

Introduction and Aims: To evaluate the technique of the knotless suture anchor for the treatment of anterior shoulder instability.

Method: 109 patients were reviewed. Each patient underwent a standardised procedure by the same surgeon under a regional interscalene block and/or general anaesthesia. An average of three anchors were placed in the 3, 4 and 5 o’clock positions. 40 patients had additional thermal shrinkage to reduce excess capsular volume. Each patient was assessed using the Constant, Rowe and Walch-Duplay scores.

Results: Follow-up period was 18 months, with an average of two years. The average operating time was one hour. Four patients (3.6%) redislocated following surgery. Two of these patients had a glenoid bone deficiency of > 20% and associated full thickness rotator cuff tears, one had an associated humeral avulsion of the glenohumeral ligament (HAGL) lesion, which was not repaired arthroscopically, and one had returned to contact sports as early as 12 weeks after surgery. Three patients had single episodes of subluxations that have not required revision. The average Rowe score was 90.8, average Constant score was 89.9 and the average Walch-Duplay score was 81.4.

Conclusion: Early results indicate that capsulolabral reconstruction using the knotless suture anchor is an effective procedure in the treatment of post-traumatic anterior shoulder instability. The incorporation of a south to north capsular shift technique during labral reattachment reduces the necessity of additional thermal to reduce redundant capsular volume. Relative contraindications of this technique include; presence of a HAGL lesion, and anterior glenoid bone deficiency. The procedure may be performed as a day case under regional anaesthesia, has a high index of patient satisfaction and is an acceptable alternative to open surgery.