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.

Economic evaluation of surgical procedures is necessary in view of emerging, often more expensive newer techniques and the budget constraints in an increasingly cost conscious NHS. The purpose of the study was to compare the cost effectiveness of open cuff repair with arthroscopic repair for moderate size tears. This was a prospective study involving 20 patients. Ten had an arthroscopic repair and 10 had an open procedure. Effectiveness was measured by pre and post-operative Oxford scores. The patients also had Constant scores done. Costs were estimated from the departmental and hospital financial data. Rotator cuff repair was an effective operation in both the groups. At the last follow up there was no statistically significant difference in the patients Oxford and Constant scores between the two methods of repair. There was no significant difference in the time in theatre, inpatient time, post-operative analgesia, number of pre and post-operative outpatient visits, physiotherapy costs and time off work between the two groups. The arthroscopic cuff repair was significantly more expensive than open repair. The incremental cost of each arthroscopic repair was £610 higher than open procedure. This was mainly in the area of direct health-care costs (instrumentation in particular). Health care policy makers are increasingly demanding evidence of cost effectiveness of a procedure. Such data is infrequently available in orthopaedics. To our knowledge there no published cost-utility analysis for the above said two types of interventions for cuff repair. Both methods of repair are effective but in our study open cuff repair is more cost effective and is likely to have better (lower) cost-utility ratio.