Clinical Results of Knot-tying Versus Knotless Suture Anchors in Arthroscopic Anteroinferior Labral Repair
- PMID: 37448384
- PMCID: PMC10337236
- DOI: 10.7759/cureus.40292
Clinical Results of Knot-tying Versus Knotless Suture Anchors in Arthroscopic Anteroinferior Labral Repair
Abstract
Background Arthroscopic repair of glenohumeral instability is becoming an increasingly common procedure. These repairs can be undertaken using knot-tying and knotless suture anchors; there is currently no clear consensus in the literature about what type of repair is most cost-effective and provides superior outcomes. The purpose of this study is to examine postoperative outcomes of patients undergoing arthroscopic anteroinferior labral repair (AALR) with either knot-tying or knotless anchors. Methods A single institution retrospective observational cohort study of 122 patients undergoing AALR from January 2014 to June 2021 was conducted. Univariate statistics were used to assess differences in demographics, operative characteristics, and postoperative outcomes between repair types; multivariate analysis was used to evaluate risk factors for recurrent instability and reoperation. Results Patients undergoing AALR with knotless anchors had a shorter case duration than those with knot-tying anchors (112.64 vs. 89.86 minutes, p<0.001). There were no significant differences between groups in the size of labral tear, presence of a glenoid bone defect, or Hill-Sachs lesion. After controlling for age, BMI, sex, glenoid bone defect, number of preoperative dislocations, and fixation type, only age (OR=0.896, p=0.010) and female sex (OR=5.341, p=0.008) were independent risk factors for recurrent instability and no factors were independent predictors of reoperation. Conclusion Patients undergoing AALR experienced similar rates of reoperation and recurrent instability regardless of whether a knot-tying or knotless repair was performed. The use of knotless suture anchors may improve cost-effectiveness due to decreased surgical time without diminishing postoperative outcomes.
Keywords: anteroinferior labral tear; arthroscopic bankart; glenohumeral instability; knot-tying suture anchor; knotless suture anchor; shoulder arthroscopy.
Copyright © 2023, Johnson et al.
Conflict of interest statement
The authors have declared financial relationships, which are detailed in the next section.
Figures
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References
-
- The epidemiology of glenohumeral joint instability: incidence, burden, and long-term consequences. Cameron KL, Mauntel TC, Owens BD. Sports Med Arthrosc Rev. 2017;25:144–149. - PubMed
-
- Epidemiology of shoulder dislocations presenting to emergency departments in the United States. Zacchilli MA, Owens BD. J Bone Joint Surg Am. 2010;92:542–549. - PubMed
-
- History of shoulder instability and subsequent injury during four years of follow-up: a survival analysis. Cameron KL, Mountcastle SB, Nelson BJ, DeBerardino TM, Duffey ML, Svoboda SJ, Owens BD. J Bone Joint Surg Am. 2013;95:439–445. - PubMed
-
- Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. Robinson CM, Howes J, Murdoch H, Will E, Graham C. J Bone Joint Surg Am. 2006;88:2326–2336. - PubMed
-
- The true recurrence rate and factors predicting recurrent instability after nonsurgical management of traumatic primary anterior shoulder dislocation: a systematic review. Wasserstein DN, Sheth U, Colbenson K, Henry PD, Chahal J, Dwyer T, Kuhn JE. Arthroscopy. 2016;32:2616–2625. - PubMed
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