title: The arthroscopic treatment of shoulder instability: bioabsorbable and standard metallic anchors produce equivalent clinical results.
abstract: OBJECTIVE
  To investigate whether there are any differences in clinical outcomes and complications between absorbable and nonabsorbable suture anchors in the treatment of shoulder instability.
  
  
  METHODS
  We performed a comprehensive search of Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, and the Cochrane Central Registry of Controlled Trials, from inception of the databases, using various combinations of keywords. Only studies focusing on clinical outcomes of patients who underwent arthroscopic shoulder stabilization with suture anchors were selected. Two authors (R.P. and L.D.B.) then evaluated the methodologic quality of each article using the Coleman Methodology Score.
  
  
  RESULTS
  Ten articles were included. Four were prospective randomized studies, 2 were prospective cohort studies, and 4 were case series. The mean modified Coleman Methodology Score was 76.2.
  
  
  CONCLUSIONS
  Given the overall good results reported after arthroscopic stabilization of the shoulder using different suture anchors, it is not possible to draw a definite and solid suggestion on which class of device is better advised for routine use. Thus the decision to use one of the anchor systems available may mostly depend on its cost-effectiveness, which should be the focus of future comprehensive research.
  
  
  METHODS
  Level IV, systematic review of Level I to IV studies.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Diaz Balzani
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: D'Adamio
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
authors.affiliation: Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England; Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy. Electronic address: n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D053441:Suture Anchors; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult