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Outcomes of Glenoid Labral Repair Using All-Suture Anchors
Alexander E Loeb1, Zachary Moore2, Matthew P Ithurburn3
1American Sports Medicine Institute, Birmingham, Alabama, USA; North Florida Orthopaedics, Tallahassee, Florida, USA.
Background:
In recent years, innovation in arthroscopic glenoid labral repair techniques has included the development of all-suture anchors. There are multiple potential advantages of all-suture anchors, including decreased bone removal, anchor migration, synovitis/chondral injury, and bone reaction. Despite these potential advantages, few studies have examined clinical outcomes of glenoid labral repair with all-suture anchors.
Purpose:
To evaluate patient-reported and return-to-sport outcomes of arthroscopic glenoid labral repairs using all-suture anchors.
Study Design:
Case series; Level of evidence, 4.
Methods:
All patients who underwent arthroscopic glenoid labral repair using all-suture anchors at our institution over a 6-year period were identified. As a part of a longitudinal data repository, we collected baseline (presurgical) and follow-up patient-reported outcome data, with a minimum follow-up time of 2 years, using the American Shoulder and Elbow Surgeons (ASES) score and the Western Ontario Shoulder Instability Index (WOSI) score. For athletes, we also collected data on return to preinjury level of sport and relevant contextual factors. We compared baseline and follow-up ASES and WOSI scores and examined the association between demographic, injury, and surgery variables and ASES/WOSI scores at follow-up.
Results:
Of 529 eligible patients, follow-up data were collected for 372 (70%). Of those, 51 underwent any type of subsequent ipsilateral shoulder surgery (14% of those with follow-up data [51/372]). In the remaining 321 patients (mean age at surgery, 23.9 years; 83% male), we collected both presurgical and follow-up outcome data (mean follow-up time, 3.3 years). Across all labral repair types, mean values significantly improved from baseline to follow-up for both the ASES (baseline, 62.1; follow-up, 92.7) and the WOSI (baseline, 47.5; follow-up, 85.4). Younger age, being a competitive athlete, and having a labral tear in the inferior location (vs not) were associated with higher ASES and WOSI scores at follow-up. Those with concomitant biceps tenodesis demonstrated lower ASES and WOSI scores at follow-up compared with those without tenodesis. Within competitive athletes (n = 201), 95% of athletes who attempted to return to preinjury level of sport were able to do so.
Conclusion:
Among patients with follow-up data, 14% underwent subsequent ipsilateral shoulder procedures. Those who didn't undergo subsequent procedures demonstrated excellent patient-reported outcomes, including large and meaningful improvements in ASES and WOSI scores and a high level of return-to-sport in athletes, after arthroscopic all-suture anchor glenoid labral repair at a mean follow-up of 3.3 years.
