Absorbable implants for open shoulder stabilization. A 7-8-year clinical and radiographic follow-up.
Eighteen consecutive patients who had recurrent, unidirectional, post-traumatic shoulder instability were included. All these patients underwent surgery using an open Bankart technique involving absorbable suture anchors. The median age at the index operation was 27 (16-50) years. One subluxation and two re-dislocations occurred during the follow-up period of 90 (80-95) months. At the 90-month control, the Rowe and Constant scores were 94 (63-100) points and 88.5 (65-100) points, respectively. The strength measurements on the index side in 90 degrees abduction revealed 8.1 (3.7-17.2) kg compared with 7.6 (2.7-17.6) kg on the contra lateral side (n.s.). The external rotation in abduction was 80 (60-95) degrees compared with 100 (70-120) degrees for the contra lateral side (p = 0.0015). Signs of minor or moderate degeneration were found in five of 18 patients (28%) on the preoperative radiographs. There was a significant continuous increase in degenerative changes during the follow-up period as seen on the seven, 33 and 90-month radiographs (p = 0.01, 0.03 and 0.01, respectively). On the 90-month radiographs, 12 of 18 patients (67%) had minor, moderate or severe degenerative changes (p = 0.0004 preoperative vs. 90 months). On the 7-month radiographs, two of 18 patients (11%) had invisible or hardly visible drill holes in conjunction with the absorbable implants. On the 90-month radiographs, 12 of 18 patients (67%) had invisible or hardly visible drill holes (p = 0.003 7 months vs. 90 months). In the long term, the method resulted in stable, well-functioning shoulders in 15 of 18 patients (83%). The stabilisation was not, however, able to prevent further increases in radiographic degenerative changes during the 7-8-year follow-up. The drill holes used for the absorbable suture anchors appeared to heal in the majority of patients during the follow-up period.
Magnusson
Lennart
L
Department of Orthopaedics, Västerås Hospital, Västerås, Sweden.
Ejerhed
Lars
L
Rostgård
Lars
L
Sernert
Ninni
N
Kartus
Jüri
J
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011108:Polymers; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D016059:Range of Motion, Articular; D012598:Sclerosis / Q000000981:diagnostic imaging / Q000209:etiology; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000209:etiology; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology* / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*
D011108:Polymers; C046409:polyglyconate