A simple and secure anchoring system for Caspari's transglenoid multiple suture technique using a biodegradable...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Sports Medicine

Background:

• The Caspari transglenoid multiple suture technique for shoulder instability can present challenges with suture management over the infraspinatus fascia.
• Developing innovative fixation methods is crucial for improving surgical outcomes in shoulder labral repairs.

Purpose of the Study:

• To introduce and evaluate the clinical efficacy of a novel anchoring system utilizing a biodegradable poly-L-lactic acid (PLLA) button.
• To assess the PLLA button's effectiveness in facilitating suture fixation for the Caspari technique in patients with shoulder instability.

Main Methods:

• A biodegradable PLLA button (8x8x1.2 mm, two holes) was employed in 28 patients undergoing shoulder repair for Bankart lesions or superior glenoid labrum detachment.
• Sutures were passed through the PLLA button and tied over it to secure the repair, with patients immobilized post-surgery.

Main Results:

• The PLLA button provided simple and secure suture fixation for the Caspari technique.
• For Bankart repairs (24 patients), the success rate was 83% (13 excellent, 7 good, 4 poor).
• For superior labral repairs (4 patients), outcomes were excellent in 3 and good in 1. Poor outcomes were associated with resubluxation in contact athletes.

Conclusions:

• The biodegradable PLLA button is an effective tool for enhancing suture fixation in the Caspari technique for shoulder instability.
• This anchoring system demonstrates good clinical efficacy and a low complication rate, with transient suprascapular nerve issues in 2 patients.