Arthroscopic treatment of anterior shoulder instability using knotless suture anchors.
OBJECTIVE
In this study, we evaluated the results of arthroscopic stabilization of the shoulder using knotless anchors and the lesions associated with anterior-inferior labrum avulsion.


METHODS
Retrospective clinical study.


METHODS
Twenty consecutive patients affected with anterior unidirectional post-traumatic shoulder instability were treated with arthroscopic reconstruction using knotless anchors. During the surgical procedure, associated lesions such as superior labrum anterior posterior (SLAP) (15%) and rotator interval (15%) were repaired. The patients were evaluated at a mean follow-up of 43 months.


RESULTS
Eighty percent of patients resumed sports activity without any limitation and 90% of patients were satisfied with the results of surgery. One patient (5%) had a recurrent dislocation; this patient resumed a contact sport activity despite medical advice. One patient (5%) related signs of shoulder insecurity at the extreme degree of abduction and external rotation; this patient had resumed sports activity with a moderate limitation and was the only patient who was not completely satisfied with the results of surgery. No significant difference was observed between the operated and the contralateral shoulder according to the Rowe and Constant scores. The mean loss of external rotation was 3 degrees . We did not have any cases of anchor loosening, nor did we find signs of shoulder degenerative osteoarthritis on the radiographs.


CONCLUSIONS
The knotless anchor seems to be a viable alternative for arthroscopic labrum repair, allowing a good capsular shift. Arthroscopic management of shoulder instability allows us to diagnose and treat associated lesions, thus improving the success rate of this type of surgery.


METHODS
Level IV, case series.
Garofalo
Raffaele
R
Department of Orthopaedics and Traumatology, University Hospital of Lausanne, Lausanne, Switzerland.
Mocci
Andrea
A
Moretti
Biagio
B
Callari
Eugenio
E
Di Giacomo
Giovanni
G
Theumann
Nicolas
N
Cikes
Alec
A
Mouhsine
Elyazid
E
D000059:Accidents; D000328:Adult; D001182:Arthroscopy / Q000706:statistics & numerical data; D001265:Athletic Injuries / Q000601:surgery; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D005260:Female; D051445:Fibrocartilage / Q000293:injuries / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000209:etiology / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D016037:Single-Blind Method; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome