title: Fewer anchors achieves successful arthroscopic shoulder stabilization surgery: 114 patients with 4 years of follow-up.
abstract: BACKGROUND
  The shoulder is the most frequently dislocated joint, with an incidence of 10 to 20 per 100,000 each year. The optimum number of anchors to use in arthroscopic stabilization is a topic of growing interest; most surgeons use 3. Our stabilization technique is to commonly use only a single suture anchor to purse-string the capsulolabral tissue up and toward the glenoid. This study aimed to ascertain whether successful stabilization can be achieved with fewer than 3 anchors.
  
  
  METHODS
  Our study comprised 114 consecutive patients with anterior instability and a Bankart lesion undergoing arthroscopic stabilization with 4 years of follow-up. Outcome was measured by Oxford Instability Score (OIS) and recurrence of instability or dislocation. Patient demographics were 86.8% male, 13.2% female, mean age of 31 years, 76.3% Hill-Sachs lesions, 13.2% bony Bankart lesions, 13.2% glenoid defects, and 9.6% SLAP lesions. The majority of patients, 71 patients (62.3%), received only 1 anchor; 40 patients (35.1%) received 2 anchors, and 3 patients (2.6%) had 3 anchors.
  
  
  RESULTS
  The mean OIS was 44.3 preoperatively and 17.3 postoperatively (P < .0001). There was no difference in OIS improvement between the patients who received a single anchor and those who received 2 or 3 anchors (P > .05). Even with minor bony Bankart lesions and glenoid defects, a single suture anchor can be sufficient. Our failure rate of 6.1% is comparable with that of other published series.
  
  
  CONCLUSIONS
  Successful shoulder stabilization can be achieved with fewer than 3 anchors, and a single anchor is usually sufficient.
authors.affiliation: Department of Orthopaedics, Dewsbury and District Hospital, Halifax, W. Yorks, UK. Electronic address: carolinejws@gmail.com.
authors.forename: Caroline
authors.initials: C
authors.lastname: Witney-Lagen
authors.affiliation: Department of Orthopaedics, Dewsbury and District Hospital, Halifax, W. Yorks, UK.
authors.forename: Namal
authors.initials: N
authors.lastname: Perera
authors.affiliation: Department of Orthopaedics, Dewsbury and District Hospital, Halifax, W. Yorks, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rubin
authors.affiliation: Department of Orthopaedics, Dewsbury and District Hospital, Halifax, W. Yorks, UK.
authors.forename: Balachandran
authors.initials: B
authors.lastname: Venkateswaran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000145:classification / Q000209:etiology / Q000517:prevention & control; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001265:Athletic Injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000145:classification / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D055502:Secondary Prevention; D012782:Shoulder; D012783:Shoulder Dislocation / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*; D053441:Suture Anchors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Shoulder; anchor; arthroscopic; dislocation; instability; stabilization