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Wallace AL, Calvo E, Ardèvol Cuesta J, Lanzetti R, Luengo-Alonso G, Rokito AS, Spencer EE, Spoliti M. Safety and efficacy of second-generation all-suture anchors in labral tear arthroscopic repairs: prospective, multicenter, 1-year follow-up study. JSES Int 2024; 8:763-768. [PMID: 39035662 PMCID: PMC11258834 DOI: 10.1016/j.jseint.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
Background This study's primary aim was to assess the safety and performance of second-generation all-soft suture anchors following arthroscopic labral tear repair. Methods This prospective, multicenter study was conducted by 6 surgeons at 6 sites in Europe and the United States between November 2018 and August 2020. Patients who required shoulder arthroscopic repair, for a range of labral injuries, were treated with a second-generation all-soft suture anchor. The primary outcome was clinical success rate (percentage of patients without signs of failure and/or reintervention) at 6 months. Secondary outcomes included clinical success rate at 12 months, intraoperative anchor deployment success rate, and patient-reported outcomes (PROs) at 6 and 12 months, including visual analog scale (VAS) pain assessment, VAS satisfaction assessment, EQ-5D-5L Index Score, EQ-5D-5L VAS Health Score, Rowe Shoulder Score for Instability, American Shoulder and Elbow Surgeons score, and Constant-Murley Shoulder Score. Serious adverse events and serious adverse device effects were collected throughout the study. Results Forty-one patients were enrolled (mean age, 28.2 years; 87.8% male, 12.2% female). Clinical success was achieved in 27/28 and 31/32 patients at 6 months and 12 months, respectively. Anchor deployment had a 100% success rate. Significant improvements over baseline were reported for all PROs except Constant-Murley Shoulder (6 months) and VAS Satisfaction Score (12 months). One patient experienced 1 serious adverse event and 1 patient experienced 1 serious adverse device effect. Conclusion Second-generation all-soft suture anchors used in this study demonstrated a high clinical success rate, a favorable safety profile, and patients exhibited significant improvement in PROs.
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Affiliation(s)
| | - Emilio Calvo
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | | | | | | | - Marco Spoliti
- Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
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Feeley SM, Kamali A, Colantonio DF, Renninger CH. Proximal Tibia Fracture Through Suture Augmentation Sites Following ACL/MCL Repairs: A Case Report. JBJS Case Connect 2024; 14:01709767-202406000-00060. [PMID: 38913812 DOI: 10.2106/jbjs.cc.24.00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
CASE A 35-year-old man sustained a proximal tibia fracture from a low-energy mechanism 1 year after anterior cruciate and medial collateral ligament repairs with suture augmentation (SA). The fracture propagated through both tibial SA anchor sites. Following intramedullary tibial nailing, he returned to his prior level of function. CONCLUSION While complications of SA for ligamentous procedures are rare, these techniques are being implemented more frequently and the full complication profile is yet to be determined. Our report documents a new complication and potential risk factors that surgeons should consider when performing SA for multiligament knee surgery in active individuals.
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Affiliation(s)
- Scott M Feeley
- Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Arash Kamali
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Donald F Colantonio
- John A. Feagin Jr. Orthopaedic Sports Medicine Fellowship, Keller Army Community Hospital, West Point, New York
| | - Christopher H Renninger
- Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Klungsøyr JA, Vagstad T, Klungsøyr PJ, Myklebust TÅ, Lund Hanssen H, Hoff SR, Drogset JO. The Arthroscopic Subscapular Sling Procedure Results in Low Recurrent Anterior Shoulder Instability at 24 Months of Follow-Up. Arthroscopy 2024:S0749-8063(24)00167-1. [PMID: 38453096 DOI: 10.1016/j.arthro.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/18/2024] [Accepted: 02/24/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE To analyze the results of the subscapular sling procedure developed for anterior shoulder instability in patients with less than 10% anterior glenoid bone loss. METHODS Patients were treated surgically with the arthroscopic subscapular sling procedure. A semitendinosus graft was used to reconstruct the anterior labrum and to establish a sling suspension around the upper part of the subscapularis tendon. The patients were followed up with radiographs (at 12 and 24 months). Magnetic resonance imaging (MRI) of the shoulder region and clinical examinations were performed at 3, 12, and 24 months. Recurrent dislocation was the primary endpoint. The Western Ontario Shoulder Instability Index (WOSI) and MRI results were secondary outcome measures. An independent physiotherapist assessed residual instability and range of motion. RESULTS Fifteen patients were included with a dislocation rate of 0% after 24 months follow-up. There was a significant clinical improvement of the WOSI score from 57% (904) at baseline to 88% (241) at 24 months (P < .001). The proportion of patients with an improvement in the WOSI Total score larger than the estimated minimal clinically important difference was 100% both at 12 and 24 months. MRI showed an intact sling in all patients. External rotation was not significantly reduced (52° at baseline vs 47° at 24 months, P = .211). Flexion and abduction were significantly improved from 152° to 174° (P = .001) and 141° to 170° (P < .001) after 24 months. The surgical procedures were completed without any intraoperative complications. CONCLUSIONS The subscapular sling procedure resulted in low recurrent shoulder instability and improved patient-reported outcome measures at 24 months of follow-up. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Jan Arild Klungsøyr
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway.
| | - Terje Vagstad
- Department of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Peter Johannes Klungsøyr
- Department of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Tor Åge Myklebust
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Håkon Lund Hanssen
- Department of Radiology and Nuclear Medicine, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Solveig Roth Hoff
- Department of Radiology, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jon Olav Drogset
- Department of Orthopedic Surgery, Trondheim University Hospital and Norwegian University of Science and Technology (NTNU) Trondheim, Norway
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Minkus M, Aigner A, Wolke J, Scheibel M. All-Suture Anchor vs. Knotless Suture Anchor for the Treatment of Anterior Shoulder Instability-A Prospective Cohort Study. J Clin Med 2024; 13:1381. [PMID: 38592204 PMCID: PMC10934154 DOI: 10.3390/jcm13051381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
All-suture or soft-anchors (SA) represent a new generation of suture anchor technology with a completely suture-based system. This study's objective was to assess Juggerknot® SA, for arthroscopic Bankart repair in recurrent shoulder instability (RSI), and to compare it to a commonly performed knotless anchor (KA) technique (Pushlock®). In a prospective cohort study, 30 consecutive patients scheduled for reconstruction of the capsulolabral complex without substantial glenoid bone loss were included and operated on using the SA technique. A historical control group was operated on using the KA technique for the same indication. Clinical examinations were performed preoperatively and 12 and 24 months postoperatively. RSI and WOSI at 24 months were the co-primary endpoints, evaluated with logistic and linear regression. A total of 5 out of 30 (16.7%) patients suffered from RSI in the SA group, one out of 31 (3.2%) in the KA group (adjusted odds ratio = 10.12, 95% CI: 0.89-115.35), and 13.3% in the SA group and 3.2% in the KAgroup had a revision. The median WOSI in the SA group was lower than in the KA group (81% vs. 95%) (adjusted regression coefficient = 10.12, 95% CI: 0.89-115.35). Arthroscopic capsulolabral repair for RSI using either the SA or KA technique led to satisfying clinical outcomes. However, there is a tendency for higher RSI and lower WOSI following the SA technique.
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Affiliation(s)
- Marvin Minkus
- Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité Universitaetsmedizin Berlin, 10117 Berlin, Germany; (M.M.)
| | - Annette Aigner
- Institute of Biometry and Clinical Epidemiology, Charité Universitaetsmedizin Berlin, 10117 Berlin, Germany
| | - Julia Wolke
- Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité Universitaetsmedizin Berlin, 10117 Berlin, Germany; (M.M.)
| | - Markus Scheibel
- Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité Universitaetsmedizin Berlin, 10117 Berlin, Germany; (M.M.)
- Department of Shoulder and Elbow Surgery, Schulthess Clinic Zurich, 8008 Zurich, Switzerland
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Seki T, Seki K, Imagama T, Okazaki T, Sakai T. Autologous Chondrocyte Implantation With Collagen Membrane Using a Knotless Suture Bridge Technique. Cureus 2024; 16:e52568. [PMID: 38249650 PMCID: PMC10800164 DOI: 10.7759/cureus.52568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 01/23/2024] Open
Abstract
Autologous chondrocyte implantation (ACI) has been covered by insurance in Japan since April 2013, expanding the range of treatments for extensive knee cartilage damage. Initially, the periosteum was used for the fixation of cultured cartilage, but since February 2019, the introduction of collagen membranes has shortened surgery time and simplified the procedure. We report a case where we used the knotless suture bridge technique for a more straightforward and secure fixation with a collagen membrane. The patient was a 61-year-old male who experienced right knee pain a year earlier when stepping downstairs. Conservative treatment at a local hospital was ineffective, and he was referred to our department. At the initial examination, the right knee had an extension of -5° and a flexion of 130°. A simple X-ray of the right knee showed osteosclerosis with a translucent bone image at the medial femoral condyle. Weight-bearing full-length X-ray of the lower limb showed a femorotibial angle (FTA) of 186°, a hip-knee-ankle (HKA) angle of 12.5° varus, a percentage of mechanical axis (%MA) of 15%, and a medial proximal tibial angle (MPTA) of 78°, indicating a significant varus deformity. CT and MRI revealed a cartilage defect of 36 mm in length and 16 mm in width and a bone defect with a maximum depth of 15 mm at the medial femoral condyle. The patient underwent surgery for a traumatic cartilage defect of the medial femoral condyle. For the bone defect, autologous bone grafting was performed, and for the cartilage defect, ACI was done. The ACI involved fixation with a collagen membrane using 1.3 mm suture tape and BC PushLock anchor (Arthrex, Naples, Florida, United States) in a knotless suture bridge technique. Additionally, hybrid closed-wedge high tibial osteotomy (HCWHTO) was performed for alignment correction. At eight months post surgery, MRI proton density sagittal images confirmed the joint surface by the cartilage layer, and the Modified Outerbridge Cartilage Repair Assessment (MOCART) score was 80. At 12 months post surgery, the Japanese version of the Knee Injury and Osteoarthritis Outcome Score (J-KOOS) improved from 46.43 to 82.14 for symptoms, 58.33 to 83.33 for pain, 95.59 to 100 for activities of daily living (ADL), 45 to 75 for sports, and 68.75 to 87.50 for quality of life (QOL). X-rays showed an FTA of 173°, an HKA of 0°, and a %MA of 58%, indicating a favorable course. The knotless suture bridge technique for collagen membrane fixation during ACI is considered a convenient and time-saving method.
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Affiliation(s)
- Toshihiro Seki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, JPN
| | - Kazushige Seki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, JPN
| | - Takashi Imagama
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, JPN
| | - Tomoya Okazaki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, JPN
| | - Takashi Sakai
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, JPN
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Ideler N, De Mesel A, Vercruysse L, Declercq G, van Riet R, Verborgt O. Clinical and radiological outcome of all-suture anchors in shoulder and elbow surgery. Shoulder Elbow 2023; 15:544-553. [PMID: 37811390 PMCID: PMC10557925 DOI: 10.1177/17585732221127433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 10/10/2023]
Abstract
Background All-suture anchors (ASAs) are noted to cause various bone reactions when used in upper limb surgery but clinical implications are unknown. Methods 88 shoulders and 151 elbows with a mean follow-up of 47.1 ± 17.7 months were invited for follow-up including clinical examination, questionnaires and radiographs. The anchor drill holes were radiographically assessed. Results At final follow up, mean DASH was 12.9 ± 13.8 and mean VAS 2.2 ± 2.4 in the shoulder population. In the elbow group mean MEPS was 91.8 ± 12.7 and mean VAS 1.5 ± 1.9. Implant-specific complications were seen in 10 elbow cases but none in the shoulder group. The mean diameter of the 1.4 mm all-suture anchor drill hole was enlarged to 2.5 ± 1.4 mm in the shoulder group and to 2.9 ± 1.0 mm in the elbow group. 50% of the 1.4 mm anchor drill holes showed abnormal morphology but these morphologic changes did not correlate with clinical outcome, complications or reoperation rate. Discussion Satisfying clinical outcomes are found in upper limb surgery using ASAs. Various bone changes are seen after implantation of an ASA, but these are not clinically relevant. Long-term consecutive follow-up data is required.
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Affiliation(s)
- Nick Ideler
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium
| | - Annelien De Mesel
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium
| | - Loïc Vercruysse
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium
| | - Geert Declercq
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium
| | - Roger van Riet
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium
- Department of Orthopedic Surgery and Traumatology, University Hospital Antwerp, Edegem, Belgium
| | - Olivier Verborgt
- Department of Orthopedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium
- Department of Orthopedic Surgery and Traumatology, University Hospital Antwerp, Edegem, Belgium
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Lee JH, Shin SJ. Revision Arthroscopic Labral Repair Using All-Suture Anchors in Patients With Subcritical Glenoid Bone Loss After Failed Bankart Repair: Clinical Outcomes at 2-Year Follow-up. Orthop J Sports Med 2023; 11:23259671231151418. [PMID: 36896097 PMCID: PMC9989405 DOI: 10.1177/23259671231151418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/09/2022] [Indexed: 03/11/2023] Open
Abstract
Background All-suture anchors have been used for primary arthroscopic Bankart repair because of their ability to minimize initial bone loss. Purpose To evaluate the clinical efficacy of using all-suture anchors in revision arthroscopic labral repair after failed Bankart repair. Study Design Case series; Level of evidence, 4. Methods Enrolled in this study were 28 patients who underwent revision arthroscopic labral repair with all-suture anchors after a failed primary arthroscopic Bankart repair. Revision surgery was determined for patients who had a frank redislocation history with subcritical glenoid bone loss (<15%), nonengaged Hill-Sachs lesion, or off-track lesion. Minimum 2-year postoperative outcomes were evaluated using shoulder range of motion (ROM), the Rowe score, the American Shoulder and Elbow Surgeons (ASES) score, apprehension, and the redislocation rate. Postoperative shoulder anteroposterior radiographs were assessed to evaluate arthritic changes in the glenohumeral joint. Results The mean patient age was 28.1 ± 6.5 years, and the mean time between primary Bankart repair and revision surgery was 5.4 ± 4.1 years. Compared with the number of suture anchors used in the primary operation, significantly more all-suture anchors were inserted in the revision surgery (3.1 ± 0.5 vs 5.8 ± 1.3, P < .001). During the mean follow-up period of 31.8 ± 10.1 months, 3 patients (10.7%) required reoperation because of traumatic redislocation and symptomatic instability. Of patients with symptoms that did not require reoperation, 2 patients (7.1%) had subjective instability with apprehension depending on the arm position. There was no significant change between preoperative and postoperative ROM. However, ASES (preoperative: 61.2 ± 13.3 to postoperative: 81.4 ± 10.4, P < .01) and Rowe (preoperative: 48.7 ± 9.3 to postoperative: 81.7 ± 13.2, P < .01) scores were significantly improved after revision surgery. Eight patients (28.6%) showed arthritic changes in the glenohumeral joint on final plain anteroposterior radiographs. Conclusion Revision arthroscopic labral repair using all-suture anchors demonstrated satisfactory 2-year clinical outcomes in terms of functional improvement. Postoperative stability was obtained in 82% of patients without recurrent shoulder instability after failed arthroscopic Bankart repair.
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Affiliation(s)
- Jae-Hoo Lee
- Department of Orthopaedic Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, Republic of Korea
| | - Sang-Jin Shin
- Department of Orthopaedic Surgery, Ewha Shoulder Disease Center, Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Sang-Jin Shin, MD, PhD, Department of Orthopaedic Surgery, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea ()
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Del Castillo Pardo de Vera JL, Pampín Martínez M, Aragón Niño I, Barajas Blanco M, Cebrián Carretero JL. Temporomandibular joint meniscopexy using the juggerknot® soft anchor system. technical note. Br J Oral Maxillofac Surg 2023; 61:327-328. [PMID: 37003847 DOI: 10.1016/j.bjoms.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
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Cole EW, Werner BC, Denard PJ. Perianchor Cyst Formation Is Similar Between All-Suture and Conventional Suture Anchors Used for Arthroscopic Rotator Cuff Repair in the Same Shoulder. Arthrosc Sports Med Rehabil 2022; 4:e949-e955. [PMID: 35747662 PMCID: PMC9210368 DOI: 10.1016/j.asmr.2022.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/14/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose The purpose of this study was to compare perianchor cyst formation between soft and hard suture anchors placed in the same patient 1 year after arthroscopic rotator cuff repair (ARCR). Methods This study reviewed patients who underwent primary ARCR using a “hybrid” technique using at least one soft anchor (FiberTak, Arthrex, Naples, FL) and one hard anchor (SwiveLock) placed in the same shoulder between January 1, 2018 and December 31, 2018. Magnetic resonance imaging was obtained at minimum 1-year postoperative to assess cyst formation (perianchor fluid signal) and rotator cuff healing. Range of motion (ROM) and patient-reported outcome measures (PROMs) were evaluated at baseline and 1-year follow up. PROMs included visual analog scale pain score, Simple Shoulder Test score, American Shoulder and Elbow Surgeon (ASES) score. Results Nineteen patients with a combined 45 hard and 26 soft suture anchors were available for follow-up at a mean of 20 months postoperatively. There was a higher proportion of grade 1 fluid signal changes in the hard anchor group compared to the soft group (62.2% to 7.7; P < .001); however, there was no difference in the incidence of cyst formation (grade 2 or 3 changes) between groups (13.3% vs 3.8%; P = .251). There was also no difference in the rate of cyst formation between biocomposite and polyether-ether-ketone-type hard anchors (18.2% vs 0%; P = .113) or between anchors placed at the greater and lesser tuberosities (10.2% vs 5.3%, P = .519). Conclusion Hard suture anchors showed increased fluid signal compared to soft suture anchors at short-term follow-up after ARCR, but there was no difference in cyst formation between anchor types.
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Affiliation(s)
- Elliott W. Cole
- Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, Oregon, U.S.A
| | - Brian C. Werner
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A
| | - Patrick J. Denard
- Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, Oregon, U.S.A
- Oregon Shoulder Institute, Medford, Oregon, U.S.A
- Address correspondence to Patrick J. Denard, M.D., Southern Oregon Orthopedics, 2780 E. Barnett Rd., Suite 200, Medford, OR, 97530, U.S.A.
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10
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Tokish JM, Brinkman JC, Hassebrock JD. Arthroscopic Technique for Distal Tibial Allograft Bone Augmentation With Suture Anchor Fixation for Anterior Shoulder Instability. Arthrosc Tech 2022; 11:e903-e909. [PMID: 35646558 PMCID: PMC9134681 DOI: 10.1016/j.eats.2022.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/08/2022] [Indexed: 02/03/2023] Open
Abstract
Recurrent instability associated with glenoid bone loss is a commonly encountered problem after anterior shoulder dislocation. Surgical management with bony augmentation can be achieved with several allograft or autograft options. Fixation strategies also vary, including screw, suture button, or suture anchor fixation. Concerns exist regarding screw fixation because of the technical difficulty of a medial portal establishment, as well as the potential for graft osteolysis. Suture button fixation for osteochondral graft fixation has been previously described. However, no description of graft fixation using suture anchors exists. We describe an arthroscopic technique for glenoid augmentation using distal tibial allograft with suture anchor fixation.
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Affiliation(s)
| | - Joseph C. Brinkman
- Address correspondence to Joseph C. Brinkman, M.D., Department of Orthopedic Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, U.S.A.
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11
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Ruiz Ibán MA, Vega Rodriguez R, Ruiz Díaz R, Pérez Expósito R, Zarcos Paredes I, Diaz Heredia J. Arthroscopic remplissage with all-suture anchors causes cystic lesions in the humerus: a volumetric CT study of 55 anchors. Knee Surg Sports Traumatol Arthrosc 2021; 29:2342-2347. [PMID: 33030611 DOI: 10.1007/s00167-020-06314-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To evaluate with computed tomography (CT) the incidence of implant-related osteolysis after implantation of two types of all-suture anchors during remplissage for the management of Hill-Sachs lesions in shoulder instability. METHODS Single-cohort, observational study with a minimum of 12 months follow-up. Twenty-five participants (19 males and 6 females; mean age 37.4 years [SD: 11.6]) with Hill-Sachs lesions requiring remplissage were evaluated with a CT performed a mean of 14.1 [3.74] months after surgery. Fifty-five all-suture anchors (19 2.3 mm Iconix and 36 1.7 mm Suturefix) were used. The volume of the bone defects was measured in the CT. Every anchor was classified into one of four groups: (1) no bone defect. (2) Partial bone defect (bone defects smaller than the drill used for anchor placement). (3) Tunnel enlargement (bone defect larger than the drill volume but smaller than twice that volume). (4) Cystic lesion (bone defect larger twice the drill volume). RESULTS No bone defect was identified in only two anchors (3.6%, 95% CI 0.4-12.5%). A partial bone defect was found in eight anchors (14.5%, 95% CI 6.5-26.7%). In 35 anchors (63.6%, 95% CI 49.6-76.2%), there was enlargement of the bone defect that was smaller than 200% the size of the drill used. Ten anchors caused bone defects larger than twice the size of the drill used (18.2%, 95% CI 9.1-30.9%). The defect size was a mean of 89 mm3 (SD: 49 mm3, minimum 0 mm3, maximum 230 mm3). CONCLUSION When using all-suture anchors in arthroscopic remplissage during instability surgery, relevant bone osteolytic defects are common at 1-year-follow-up. Cystic defects larger than twice the volume of the resected bone during implantation develop in one in six anchors and significant tunnel widening will develop in another three out of five anchors. This bone loss effectively increases the size and depth of the Hill-Sachs lesions but does not seem to affect short-term clinical outcomes. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
| | - Rosa Vega Rodriguez
- Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Raquel Ruiz Díaz
- Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Roque Pérez Expósito
- Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Irene Zarcos Paredes
- Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Jorge Diaz Heredia
- Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
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12
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Ruiz Ibán MA, Vega Rodriguez R, Díaz Heredia J, Pérez Expósito R, Zarcos Paredes I, Ruiz Díaz R. Arthroscopic Bankart repair with all-suture anchors does not cause important glenoid bone osteolysis: a volumetric CT study of 143 anchors. Knee Surg Sports Traumatol Arthrosc 2021; 29:2152-2158. [PMID: 32754864 DOI: 10.1007/s00167-020-06192-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate with computed tomography (CT) the incidence of anchor-related osteolysis after implantation of two types of all-suture anchors for the management of labral lesions in shoulder instability. METHODS Single-cohort, observational study with 12-month follow-up. Thirty-three participants (27 males/6 females; age 38.3 years [SD 11.3]) with anterior labral lesions in which 143 all-suture anchors (71 Iconix 1.4 mm and 72 Suturefix 1.7 mm) were implanted were evaluated with a CT performed a mean of 15.4 [3.85] months after surgery. The volume of the bone defects was measured in the CT. Every anchor was classified into one of four groups: (1) no bone defect. (2) Partial bone defect (defects smaller than the drill used for anchor placement). (3) Tunnel enlargement (defects larger than the drill volume but smaller than twice that volume). (4) Cystic lesion (defects larger than twice the drill volume). RESULTS No bone defect was identified in 16 anchors (11.2%, [95% CI 6.5-17.5%]). A partial bone defect was found in 84 anchors (58.7% [50.2-66.9%]). Tunnel enlargement was found in 43 anchors (30.11% [22.6-37.6%]). No anchor caused cystic lesions (0% [0-2.5%]). The defect volume was a mean of 27.8 mm3 (SD 18.4 mm3, minimum 0 mm3, maximum 94 mm3). Neither the position in the glenoid nor the type of implant used had a significant effect in the type or size of the defects. CONCLUSION When using all-suture anchors in the glenoid during instability surgery, relevant bone osteolytic defects are rare at 1-year follow-up. Most anchor insertion tunnels will fill completely (11%) or partially (59%) with bone. Tunnel enlargement will develop in 30% of anchors. No cystic defects larger than 0.125 cm3 were observed. There is a low risk that all-suture anchors cause significant osteolytic bone defects in the glenoid. These implants can be used safely. Level of evidence IV.
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Affiliation(s)
- Miguel Angel Ruiz Ibán
- Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain.
| | - Rosa Vega Rodriguez
- Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Jorge Díaz Heredia
- Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Roque Pérez Expósito
- Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Irene Zarcos Paredes
- Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
| | - Raquel Ruiz Díaz
- Investigation Performed at Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar km 9,100, 28046, Madrid, Spain
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Pantekidis I, Malahias MA, Kokkineli S, Brilakis E, Antonogiannakis E. Comparison between all-suture and biocomposite anchors in the arthroscopic treatment of traumatic anterior shoulder instability: A retrospective cohort study. J Orthop 2021; 24:264-270. [PMID: 33867751 DOI: 10.1016/j.jor.2021.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/01/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022] Open
Abstract
Purpose Suture anchors have revolutionized arthroscopic surgery, enabling direct soft tissue-to-bone repair. There are many types of anchors still used in arthroscopic shoulder operations. We sought to compare the clinical outcome of all-suture and biocomposite anchors when used in arthroscopic Bankart repair for patients suffering from anterior shoulder instability. Methods A single-center retrospective cohort study of 30 patients (mean age: 26.6 years, SD: 8.8 years, male/female ratio: 5/1, mean follow up: 28 months, SD: 23.8, range: 12-92) with anterior shoulder instability was conducted. Patients were divided into 2 groups based upon the type of suture anchors used for the Bankart repair: group A (14 patients) used only all-suture anchors and group B (16 patients) used only biocomposite anchors. Outcomes reported were postoperative dislocations, positive shoulder apprehension test, self-reported sense of shoulder instability, return to activities of daily living, return to sports, patient satisfaction and complications. Patient reported outcome measures (PROMs) used were the Rowe Score for Instability, Constant Shoulder Score, Walch Duplay Score, The American Shoulder and Elbow Surgeons (ASES) Shoulder Score, Oxford Shoulder Instability Score and external rotation at 90° of arm abduction, external rotation at 0° of arm abduction, forward flexion, abduction, adduction and internal rotation. Results Rates of postoperative shoulder dislocation demonstrated no significant difference between the 2 groups (p > .05). Four postoperative dislocations happened, two in each group (14.3% and 12.5% for all suture only and biocomposite only groups, respectively), with three of them being traumatic. In addition, no significant differences were observed amongst groups regarding shoulder apprehension test (group A: 85.7% vs. group B: 93.8%), sense of shoulder instability (7.1% vs. 6.3%), return to activities of daily living (group A: 85.7% vs. group B: 93.8%), return to sports (group A: 85.7% vs. group B: 87.5%), patient satisfaction (moderate level: group A 21.4% vs. group B 12.5%), and PROMs. Conclusion The short-term failure rate and clinical/functional outcomes of arthroscopic Bankart repair using all-suture anchors is similar to the use of biocompatible anchors. Level of evidence Level III, retrospective cohort study.
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Affiliation(s)
- Ioannis Pantekidis
- 3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece
| | | | - Stefania Kokkineli
- 3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece
| | - Emmanouil Brilakis
- 3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece
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Lee JH, Kang JS, Park I, Shin SJ. Serial Changes in Perianchor Cysts Following Arthroscopic Labral Repair Using All-Suture Anchors. Clin Orthop Surg 2020; 13:229-236. [PMID: 34094014 PMCID: PMC8173234 DOI: 10.4055/cios20024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/14/2020] [Accepted: 07/10/2020] [Indexed: 11/21/2022] Open
Abstract
Backgroud Changes in perianchor cysts around the all-suture anchors, which demonstrate distinguished features from the biocomposite anchors, have not been revealed sufficiently. The purpose of this study was to investigate serial changes of perianchor cysts according to the location of the inserted anchor in the glenoid in arthroscopic labral repair using all-suture anchors. Methods We enrolled 43 patients who underwent computed tomography (CT) immediately postoperatively and CT arthrogram (CTA) at 1 year or 2 years after arthroscopic labral repair using a 1.3-mm all-suture anchor for recurrent anterior shoulder dislocation with or without a superior labral tear from anterior to posterior and a posterior labral tear. The mean diameter and tissue density (HU) of perianchor cysts were measured depending on the location in the glenoid. Clinical outcomes, labral healing, and redislocation rate were evaluated at 2 years after surgery. Results On functional assessment, the mean American Shoulder and Elbow Surgeons score and Rowe score improved statistically significantly after surgery (from 47.9 ± 14.3 preoperatively to 90.1 ± 9.6 postoperatively and from 45.3 ± 12.4 preoperatively to 92.2 ± 10.1 postoperatively, respectively; p < 0.01). Postoperative redislocations were found in 2 patients (4.7%). In radiological evaluation, the mean diameter of perianchor cysts at postoperative 1 year (3.24 ± 0.65 mm) was significantly larger than the immediate postoperative diameter; however, there was no significant difference between postoperative 1 year and 2 years (3.23 ± 0.57 mm). Tissue density at the center of cysts demonstrated no significant difference between 1 and 2 year postoperatively (107.7 ± 29.8 HU [superior], 99.7 ± 31.7 HU [anteroinferior], and 105.1 ± 25.0 HU [posterior] vs. 109.1 ± 26.1 HU [superior], 106.4 ± 30.3 HU [anteroinferior], and 111.0 ± 32.9 HU [posterior]). The mean diameter of perianchor cysts in the anteroinferior position was largest compared with that in superior or posterior positions. Conclusions Perianchor cysts associated with all-suture anchors enlarged significantly within 1 year after arthroscopic labral repair regardless of the insertion location in the glenoid. However, the size and tissue density of perianchor cysts were similar at postoperative 1 and 2 years, and satisfactory stability and clinical outcomes were obtained.
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Affiliation(s)
- Jae-Hoo Lee
- Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jun-Seok Kang
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - In Park
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Sang-Jin Shin
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul, Korea
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Jin S, Chun YM. Peri-anchor cyst formation after arthroscopic bankart repair: comparison between biocomposite suture anchor and all-suture anchor. Clin Shoulder Elb 2020; 23:178-182. [PMID: 33330255 PMCID: PMC7726366 DOI: 10.5397/cise.2020.00290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 11/30/2022] Open
Abstract
Background The purpose of this study is to investigate clinical outcomes and radiological findings of cyst formation in the glenoid around suture anchors after arthroscopic Bankart repair with either biocomposite suture anchor or all-suture anchor in traumatic anterior shoulder instability. We hypothesized that there would be no significant difference in clinical and radiological outcomes between the two suture materials. Methods This retrospective study reviewed 162 patients (69 in group A, biocomposite anchor; 93 in group B, all-suture anchor) who underwent arthroscopic Bankart repair of traumatic recurrent anterior shoulder instability with less than 20% glenoid defect on preoperative en-face view three-dimensional computed tomography. Patient assignment was not randomized. Results At final follow-up, the mean subjective shoulder value, Rowe score, and University of California, Los Angeles shoulder score improved significantly in both groups. However, there were no significant differences in functional shoulder scores and recurrence rate (6%, 4/69 in group A; 5%, 5/93 in group B) between the two groups. On follow-up magnetic resonance arthrography/computed tomography arthrography, the incidence of peri-anchor cyst formation was 5.7% (4/69) in group A and 3.2% (3/93) in group B, which was not a significant difference. Conclusions Considering the low incidence of peri-anchor cyst formation in the glenoid after Bankart repair with one of two anchor systems and the lack of association with recurrence instability, biocomposite and all-suture anchors in Bankart repair yield satisfactory outcomes with no significant difference.
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Affiliation(s)
- Seokhwan Jin
- Department of Orthopedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Min Chun
- Department of Orthopedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Ro K, Pancholi S, Son HS, Rhee YG. Perianchor Cyst Formation After Arthroscopic Rotator Cuff Repair Using All-Suture-Type, Bioabsorbable-Type, and PEEK-Type Anchors. Arthroscopy 2019; 35:2284-2292. [PMID: 31350085 DOI: 10.1016/j.arthro.2019.03.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/08/2019] [Accepted: 03/14/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE This study aimed to identify the difference in postoperative perianchor bone reactions in different groups of patients who underwent rotator cuff tear repairs with all-suture-, bioabsorbable screw-, and PEEK (polyether ether ketone)-type suture anchors. Furthermore, the rate of rotator cuff retear and its association with perianchor bone reactions based on the different anchors used were investigated. Moreover, their impact on the clinical outcome of patients was examined. METHODS The study included 213 patients who underwent arthroscopic single-row repair and were divided into 3 groups according to the suture anchor used: all-suture (n = 137), biodegradable (n = 36), and PEEK (n = 40) anchor groups. The clinical outcomes and magnetic resonance imaging findings were evaluated at a mean follow-up of 9.6 months. The perianchor bone reaction at the anchor site was categorized according to grades. Patients were classified based on repair integrity into the healed and retear groups with Sugaya type I to III and Sugaya type IV to V, respectively. RESULTS No statistically significant differences in Constant scores and retear rates were observed between the groups (P = .934 and P = .548, respectively). Magnetic resonance imaging showed that the total number of perianchor cysts formed postoperatively was 23 (10.8% [23 of 213 patients]). Moreover, the proportions of perianchor cysts were 8.8%, 16.7%, and 12.5% in the all-suture-type, bioabsorbable-, and PEEK-type anchor groups, respectively (P = .485). In the retear group, the incidence rate was significantly increased with higher grades of perianchor bone reaction (P = .001). The tear size and perianchor bone reaction were found to be independent factors that affected the incidence of retear. CONCLUSIONS Perianchor cyst formation was observed in 10.8% of cases after the use of suture anchors for arthroscopic rotator cuff repair. No significant differences were observed among all-suture-type, bioabsorbable-type, and PEEK-type anchors in terms of visual analog scale and Constant scores, retear rates, and perianchor bone reactions. However, the retear rate was associated with a greater perianchor cystic reaction and larger tear size. LEVEL OF EVIDENCE Level III, retrospective comparative trial.
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Affiliation(s)
- Kyunghan Ro
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Samyak Pancholi
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyuck Sung Son
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yong Girl Rhee
- Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Sgaglione NA. Editorial Commentary: Shoulder Repair All-Suture Fixators: Anchors Away or Tell Us Why Not? Arthroscopy 2019; 35:1359-1361. [PMID: 31054715 DOI: 10.1016/j.arthro.2019.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/17/2019] [Indexed: 02/02/2023]
Abstract
The current array of shoulder repair anchors, techniques, and constructs vary greatly and offer many choices to optimize soft-tissue healing to bone. The widely used all-suture anchor designs represent an innovative option that allows for versatile delivery and a low-profile anchor construct that minimizes bone drilling and preserves native bone. Various reports of tissue reactions to copolymer and biocomposite materials and now all-suture anchors have been published raising concerns in some cases over safety, adverse events, and clinical performance. Other studies have described reactions in which the clinical correlative significance remains unclear. Determination of what matters and what is significant will help to decide if radiographic tunnel enlargement does occur over time and if it changes our clinical decision-making and choice of which anchors to use.
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Lee JH, Park I, Hyun HS, Kim SW, Shin SJ. Comparison of Clinical Outcomes and Computed Tomography Analysis for Tunnel Diameter After Arthroscopic Bankart Repair With the All-Suture Anchor and the Biodegradable Suture Anchor. Arthroscopy 2019; 35:1351-1358. [PMID: 30987905 DOI: 10.1016/j.arthro.2018.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the clinical outcomes and radiological findings at the anchor site after arthroscopic Bankart repair with all-suture anchors and biodegradable suture anchors in patients with recurrent anterior shoulder dislocation. METHODS The patients who underwent arthroscopic Bankart repair were divided into 2 groups depending on the type of the suture anchor used in different periods. Power analysis was designed based on the postoperative Rowe score. Clinical outcomes, including the Rowe score, American Shoulder and Elbow Surgeons score, subjective instability, and redislocation rates were evaluated. In all patients enrolled, the tunnel diameter of the anchor was assessed with computed tomography arthrogram at 1 year postoperatively. The Institutional Review Board of Ewha Womans University approved this study (no. EUMC 2017-05-058). RESULTS A total of 67 patients were enrolled: 33 underwent surgery with a 1.3-mm (single-loaded) or 1.8-mm (double-loaded) all-suture anchor (group A), and 34 underwent surgery with a 3.0-mm biodegradable anchor (10.8 mm in length, 30% 1,2,3-trichloropropane/70% poly-lactide-co-glycolic acid) (group B). There were no significant differences in clinical outcomes between groups A and B in the American Shoulder and Elbow Surgeons score (preoperatively, 51.2 ± 13.7 vs 47.7 ± 12.2; 2 years postoperatively, 88.5 ± 12.3 vs 89.7 ± 10.9; P = .667) and Rowe score (preoperatively, 41.4 ± 10.5 vs 41.3 ± 9.4; 2 years postoperatively, 87.9 ± 14.9 vs 88.5 ± 14.6; P = .857). Postoperative redislocation (6.1% vs 5.9%, P = .682) and subjective instability rate (12.2% vs 17.7%, P = .386) of both groups showed no significant difference. Average tunnel diameter increment was significantly greater with the 1.8-mm all-suture anchor (2.8 ± 0.9 mm) than the 1.3-mm all-suture anchor (1.2 ± 0.8 mm) and 3.0-mm biodegradable anchor (0.8 ± 1.2 mm) (P < .001). CONCLUSIONS Arthroscopic Bankart repair with the all-suture anchor showed comparable clinical outcomes and postoperative stability as the conventional biodegradable suture anchor at 2 years after surgery. Tunnel diameter increment of the all-suture anchor was significantly greater than that of the biodegradable suture anchor at the 1-year computed tomography analysis. Although tunnel diameter increment was greater with the all-suture anchor, it did not influence the clinical outcomes. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Jae-Hoo Lee
- Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea
| | - In Park
- Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Hwan-Sub Hyun
- Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Sang-Woo Kim
- Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Sang-Jin Shin
- Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea.
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Ryu JH, Kang JR, Ryu RK. Arthroscopic Bankart Reconstruction with Minimal Bone Loss. OPER TECHN SPORT MED 2019. [DOI: 10.1053/j.otsm.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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