Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;29(7):2077-2084.
doi: 10.1007/s00167-020-06057-7. Epub 2020 May 18.

Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up

Isabella T Wu  1 , Vishal S Desai  1 , Devin R Mangold  1 , Christopher L Camp  1 , Jonathan D Barlow  1 , Joaquin Sanchez-Sotelo  1 , Diane L Dahm  1 , Aaron J Krych  2
Affiliations

Comparable clinical outcomes using knotless and knot-tying anchors for arthroscopic capsulolabral repair in recurrent anterior glenohumeral instability at mean 5-year follow-up

Isabella T Wu et al. Knee Surg Sports Traumatol Arthrosc. 2021 Jul.

Abstract

Purpose: To compare rates of recurrent instability, revision surgery and functional outcomes following arthroscopic anterior capsulolabral repair for recurrent anterior instability using knot-tying versus knotless suture anchor techniques.

Methods: Patients who had undergone arthroscopic anterior labrum and capsular repair for recurrent anterior glenohumeral instability using knotless anchors were identified. Those with minimum 2-year follow-up were matched (1:2) to knot-tying anchor repair patients. Rates of failure and recurrent instability were compared, as well as Visual Analog Scale (VAS), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), University of California Los Angeles (UCLA) and Rowe scores.

Results: One hundred and two patients (89 males, 13 females) with a mean age of 24.3 ± 9.6 were included. Repair was performed with knotless anchors in 34 and knot-tying anchors in 68 shoulders. At mean follow-up of 4.8 ± 2.5 years, re-dislocation rates between groups were not significantly different (knotless anchor: 9% versus knot-tying group: 15%, n.s.), but the knot-tying group showed a higher re-subluxation rate (p = 0.039). 12 (18%) revisions were performed in the knot-tying group at a mean 2.9 years after surgery and 1 (3%) revision in the knotless anchors group at 1.4 years (n.s.). There was no difference in mean VAS with use (1.3 ± 1.9 versus 0.8 ± 1.5, n.s.), SANE scores (91.8 ± 12.7 versus 92.0 ± 11.0, n.s.), QuickDASH scores (4.1 ± 5.5 versus 3.0 ± 6.5, n.s.), UCLA Shoulder Score (32.5 ± 3.6 versus 33.2 ± 3.1, n.s.), or Rowe scores (90.5 ± 18.5 versus 92.2 ± 16.6, n.s.) between knotless and knot-tying groups, respectively. VAS at rest was higher in the knotless group (0.7 ± 1.5 vs 0.1 ± 0.4, p = 0.021).

Conclusions: Knotless anchors demonstrated similar rates of re-dislocation and revision surgery, and lower rates of recurrent subluxation, compared to knot-tying anchors. Patients achieved good-to-excellent functional outcomes. This supports the efficacy of knotless anchors as an alternative to knot-tying anchors for arthroscopic anterior labral repair of recurrent anterior shoulder dislocation.

Level of evidence: III.

Keywords: Anterior capsulolabral repair; Anterior glenohumeral instability; Anterior shoulder instability; Arthroscopic labral repair; Bankart repair; Knotless anchor; Shoulder instability; Subluxation.

PubMed Disclaimer

References

    1. Amstutz HC, Sew AH, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res 155:7–20
    1. Aydin N, Unal MB, Asansu M, Tok O (2017) Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations. J Orthop Surg (Hong Kong) 25:2309499017718952 - DOI
    1. Beaton DE, Wright JG, Katz JN (2005) Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Jt Surg Am 87:1038–1046
    1. Brown L, Rothermel S, Joshi R, Dhawan A (2017) Recurrent instability after arthroscopic Bankart reconstruction: a systematic review of surgical technical factors. Arthroscopy 33:2081–2092 - PubMed
    1. Castagna A, Markopoulos N, Conti M, Delle Rose G, Papadakou E, Garofalo R (2010) Arthroscopic Bankart suture-anchor repair: radiological and clinical outcome at minimum 10 years of follow-up. Am J Sports Med 38:2012–2016 - DOI