Johnson Andrea H, Brennan Jane C, Lashgari Cyrus J, Petre Benjamin M, Turcotte Justin J, Redziniak Daniel E
Orthopedics, Anne Arundel Medical Center, Annapolis, USA.
Orthopedic Research, Anne Arundel Medical Center, Annapolis, USA.
Cureus. 2023 Jun 12;15(6):e40292. doi: 10.7759/cureus.40292. eCollection 2023 Jun.
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.
背景 肩关节镜下修复盂肱关节不稳正成为一种越来越常见的手术。这些修复可以使用打结和无结缝合锚钉进行；目前文献中对于哪种修复方式最具成本效益且能提供更好的结果尚无明确共识。本研究的目的是检查接受关节镜下前下盂唇修复（AALR）并使用打结或无结锚钉的患者的术后结果。方法 对2014年1月至2021年6月期间接受AALR的122例患者进行了单机构回顾性观察队列研究。使用单变量统计评估修复类型之间在人口统计学、手术特征和术后结果方面的差异；多变量分析用于评估复发性不稳和再次手术的危险因素。结果 接受无结锚钉AALR的患者手术时间比接受打结锚钉的患者短（112.64分钟对89.86分钟，p<0.001）。两组在盂唇撕裂大小、肩胛盂骨缺损的存在或Hill-Sachs损伤方面无显著差异。在控制年龄、体重指数、性别、肩胛盂骨缺损、术前脱位次数和固定类型后，只有年龄（OR=0.896，p=0.010）和女性性别（OR=5.341，p=0.008）是复发性不稳的独立危险因素，且没有因素是再次手术的独立预测因素。结论 无论进行打结还是无结修复，接受AALR的患者再次手术和复发性不稳的发生率相似。使用无结缝合锚钉可能由于手术时间缩短而提高成本效益，同时不降低术后结果。
