Pantekidis Ioannis, Malahias Michael-Alexander, Kokkineli Stefania, Brilakis Emmanouil, Antonogiannakis Emmanouil
3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece.
J Orthop. 2021 Mar 27;24:264-270. doi: 10.1016/j.jor.2021.03.011. eCollection 2021 Mar-Apr.
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.
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.
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.
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 III, retrospective cohort study.
缝合锚钉彻底改变了关节镜手术，实现了软组织与骨的直接修复。在关节镜下肩部手术中仍使用多种类型的锚钉。我们试图比较全缝合锚钉和生物复合材料锚钉用于关节镜下Bankart修复治疗前肩不稳患者的临床效果。
对30例前肩不稳患者（平均年龄：26.6岁，标准差：8.8岁，男女比例：5/1，平均随访时间：28个月，标准差：23.8，范围：12 - 92个月）进行单中心回顾性队列研究。根据Bankart修复所用缝合锚钉的类型将患者分为2组：A组（14例患者）仅使用全缝合锚钉，B组（16例患者）仅使用生物复合材料锚钉。报告的结果包括术后脱位、肩部恐惧试验阳性、自我报告的肩部不稳感、恢复日常生活活动、恢复运动、患者满意度和并发症。使用的患者报告结局指标（PROMs）包括不稳定的Rowe评分、Constant肩部评分、Walch Duplay评分、美国肩肘外科医师学会（ASES）肩部评分、牛津肩部不稳评分以及手臂外展90°时的外旋、手臂外展0°时的外旋、前屈、外展、内收和内旋。
两组术后肩部脱位发生率无显著差异（p > 0.05）。发生了4例术后脱位，每组2例（仅全缝合组和仅生物复合材料组分别为14.3%和12.5%），其中3例为创伤性脱位。此外，两组在肩部恐惧试验（A组：85.7% vs. B组：93.8%）、肩部不稳感（7.1% vs. 6.3%）、恢复日常生活活动（A组：85.7% vs. B组：93.8%）、恢复运动（A组：85.7% vs. B组：87.5%）、患者满意度（中等水平：A组21.4% vs. B组12.5%）和PROMs方面均未观察到显著差异。
使用全缝合锚钉进行关节镜下Bankart修复的短期失败率和临床/功能结果与使用生物相容性锚钉相似。
III级，回顾性队列研究。
