CLINICAL OUTCOME OF ARTHROSCOPIC ANTERIOR STABILISATION OF SHOULDER USING ABSORBABLE KNOTLESS SUTURE ANCHORS.

Abstract

Introduction: Arthroscopic stabilisation of shoulder joint for instability following a traumatic dislocation is gaining popularity. It has various advantages like being minimally invasive, causes minimal damage to the shoulder muscles, quicker rehabilitation, minimal loss of external rotation, and addresses the pathology. This can be performed using non-absorbable suture anchors to repair the Bankart’s lesion, which involves arthroscopic knot tying. Recently, devices, which avoid tying knots, and are absorbable, have been developed for arthroscopic shoulder stabilisation.

Aim: To evaluate the clinical results of arthroscopic Bankart’s repair using knotless, bio-absorbable suture anchor device.

Methods: A total of 32 patients with recurrent anterior dislocation of shoulder of traumatic origin underwent arthroscopic stabilisation using absorbable knotless suture anchors (Mitek U.K.). Average follow up was 2.4 years. Oxford shoulder instability score were used to evaluate clinical outcomes.

Results: The average age of patients at surgery was 24 (18–28). The average number of dislocations per patient were three. The average hospital stay was 1.1 days. The mean operating time was 70 minutes. 90.6 % (29 out of 32) had no further instability or dislocation. The recurrence rate was 9.4% (3 out of 32). The two redislocations required open repair and one patient has a residual instability. The average Oxford instability score was 22. All the patients returned to their pre-operative occupation. Of the 7 keen sportsmen, 5 returned to their contact sports at pre-injury level and 2 returned to their contact sports at a slightly lower level. In two cases we had breakage of anchor loop intraoperatively. Two patients had initial stiffness, which eventually resolved. No other complication was noted.

Conclusion: The clinical outcome of arthroscopic stabilisation of shoulder using knotless bio-absorbable suture anchors are good and are comparable to other methods of arthroscopic Bankart’s repair. The advantages are that the anchors are absorbable and there is no knot tying involved.