title: A simple and secure anchoring system for Caspari's transglenoid multiple suture technique using a biodegradable poly-l-lactic acid button.
abstract: To manage a difficulty in tying sutures over the infraspinatus fascia when using Caspari's transglenoid multiple suture technique, we developed a new anchoring system using a biodegradable poly-L-lactic acid (PLLA) button and investigated its clinical efficacy in 28 patients who were followed-up for more than 2 years postoperatively (mean, 26.5 months). Twenty-four patients had Bankart lesions and 4 had detachment of the superior glenoid labrum. The mean age at operation was 22.1 years. The PLLA button measured 8 x 8 x 1.2 mm and had two holes. After multiple sutures were inserted by the routine Caspari technique (mean, 7.3 sutures), the sutures were divided into 2 bundles, passed through the holes in the button, and tied over it on the posterior scapular neck under traction. The arm was immobilized in a Velpeau bandage for 3 weeks after Bankart repair and for 1 to 2 weeks after superior labral repair. The results of Bankart repair were excellent in 13 patients, good in 7, and poor in 4 according to Rowe's rating scale (success rate, 83%), while the outcome of superior labral repair was excellent in 3 and good in 1 according to our own criteria. All 4 patients who showed a poor outcome were contact athletes who developed resubluxation postoperatively. There were no complications, but transient damages to the suprascapular nerve occurred in 2 patients. In conclusion, the PLLA button provided simple and secure suture fixation for the Caspari technique.
authors.affiliation: Department of Orthopaedic Surgery, Osaka Kosei-Nenkin Hospital, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yoneda
authors.forename: K
authors.initials: K
authors.lastname: Hayashida
authors.forename: K
authors.initials: K
authors.lastname: Izawa
authors.forename: K
authors.initials: K
authors.lastname: Shimada
authors.forename: K
authors.initials: K
authors.lastname: Shino
mesh_terms: D000293:Adolescent; D000328:Adult; D020679:Arthroscopes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers; D011183:Postoperative Complications / Q000209:etiology; D012783:Shoulder Dislocation / Q000473:pathology / Q000601:surgery*; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery; D013525:Surgical Instruments; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)