A 7-year prospective, randomized, clinical, and radiographic study after arthroscopic Bankart reconstruction using 2 different types of absorbable tack.
BACKGROUND
Recent studies have shown that techniques for arthroscopic Bankart reconstruction using suture anchors or tacks can equal the results after an open procedure in the treatment of posttraumatic, recurrent, unidirectional shoulder instability. Which kind of technique and which implants to be used still need further study.


OBJECTIVE
The aim of this study was to compare the clinical and radiographic results after arthroscopic Bankart reconstruction using 2 different types of absorbable implants.


METHODS
Randomized controlled trial; Level of evidence, 1.


METHODS
A randomized series of 40 patients who had recurrent shoulder instability underwent reconstruction involving either polygluconate-B polymer or self-reinforced poly-L-lactic acid polymer tack implants. The patients underwent radiographic and clinical assessments preoperatively and at 7 years. Blood levels of C-reactive protein were analyzed preoperatively and postoperatively.


RESULTS
The radiographic visibility of the drill holes was significantly (P = .0001) greater in the poly-L-lactic acid polymer group than in the polygluconate-B polymer group. The failure rate in terms of stability was 5 of 36 (14%) after 7 years and, as previously reported by Magnusson et al, 2 of 40 (5%) after 2 years. Analyses preoperatively and postoperatively of C-reactive protein revealed no significant difference between the groups. No significant differences were found between the groups in terms of strength in abduction, range of motion, and Rowe or Constant scores.


CONCLUSIONS
Seven years after Bankart repair using either implant, the overall clinical results were satisfactory. The visibility of the drill holes was significantly greater after using poly-L-lactic acid polymer implants.
Elmlund
Anna O
AO
Department of Orthopedics, NU Hospital, Trollhättan and Uddevalla, Sweden. anna.elmlund@ds.se
Kartus
Jüri
J
Rostgård-Christensen
Lars
L
Sernert
Ninni
N
Magnusson
Lennart
L
Ejerhed
Lars
L
D020341:Absorbable Implants / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D019344:Lactic Acid / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000009:adverse effects*; D011446:Prospective Studies; D011859:Radiography; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)