de Groot S Joseph, Arner Justin W, Smith Clair N, Bradley James P
Burke and Bradley Orthopedics, University of Pittsburgh Medical Center. UPMC St. Margaret, 200 Medical Arts Building, Suite 4010, 200 Delafield Road, Pittsburgh, PA 15215 USA. Email:
Am J Orthop (Belle Mead NJ). 2018 Dec;47(12). doi: 10.12788/ajo.2018.0101.
The use of knotless suture anchors has increased in popularity; however, there is a paucity of literature examining the difference in clinical outcomes with traditional knotted fixation. It was hypothesized that knotless fixation would provide superior clinical outcomes, improved return to play (RTP), and lower revision rates as compared with traditional knotted fixation in the repair of SLAP IIb tears. Seventy-four athletes who underwent arthroscopic SLAP IIb repair with traditional (n = 42) and knotless anchors (n = 32) by a single surgeon were evaluated after a minimum 2-year follow. Demographic and surgical data, RTP, Kerlan-Jobe Orthopaedic Clinic (KJOC) score, American Shoulder and Elbow Surgeons (ASES) score, stability, strength, and pain scores were compared. Knotless anchors had slightly higher RTP (93.5% vs 90.2%, P = .94) and RTP at the same level (58.1% vs 53.7% P = .81) compared with knotted fixation, but the difference did not reach statistical significance. Knotless anchors were less likely to require revision surgery than traditional anchors (9% vs 17%, P = .50), but the difference was not statistically significant. When comparing knotless and traditional knotted suture anchor repair of type llb SLAP tears, knotless fixation required less revision surgery and had higher RTP, ASES, and KJOC scores; however, statistical significance was not achieved in this relatively small cohort.
无结缝线锚钉的使用越来越普遍；然而，关于传统打结固定与无结固定在临床疗效上差异的文献却很少。研究假设，在修复SLAP IIb型损伤时，与传统打结固定相比，无结固定将提供更优的临床疗效、更好的重返运动（RTP）率以及更低的翻修率。74名接受关节镜下SLAP IIb修复的运动员，由同一名外科医生分别采用传统锚钉（n = 42）和无结锚钉（n = 32）进行治疗，至少随访2年后进行评估。比较了人口统计学和手术数据、RTP、Kerlan-Jobe骨科诊所（KJOC）评分、美国肩肘外科医生（ASES）评分、稳定性、力量和疼痛评分。与打结固定相比，无结锚钉的RTP略高（93.5%对90.2%，P = 0.94），且在同一水平的RTP也略高（58.1%对53.7%，P = 0.81），但差异未达到统计学意义。与传统锚钉相比，无结锚钉需要翻修手术的可能性更小（9%对17%，P = 0.50），但差异也无统计学意义。在比较无结和传统打结缝线锚钉修复IIb型SLAP损伤时，无结固定所需的翻修手术更少，且RTP、ASES和KJOC评分更高；然而，在这个相对较小的队列中未达到统计学意义。
