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Arthroscopic and open shoulder stabilization using absorbable implants. A clinical and radiographic comparison of two
1Department of Orthopaedics, Norra Alvsborg Hospital, Trollhättan, Sweden. juri.kartus@trollhattan.mail.telia.com
Summary
This study compared open and arthroscopic Bankart lesion repairs for shoulder instability. Arthroscopic repair showed better external rotation, though both methods prevented re-dislocations without affecting clinical outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomaterials Engineering
Background:
- Recurrent post-traumatic shoulder instability, often associated with Bankart lesions, significantly impacts patient quality of life.
- Surgical reconstruction aims to restore shoulder stability and function, with open and arthroscopic techniques being common approaches.
- The choice of fixation device and surgical approach may influence clinical and radiographic outcomes.
Purpose of the Study:
- To compare the clinical and radiographic outcomes of open versus arthroscopic Bankart lesion reconstruction for recurrent shoulder instability.
- To evaluate the efficacy of absorbable suture anchors (TAG) in open repair versus arthroscopic fixators (Suretac).
Main Methods:
- A comparative study involving 33 patients (36 shoulders) with recurrent unidirectional shoulder instability and Bankart lesions.
- Group A: Open Bankart reconstruction using 3.7-mm TAG suture anchors. Group B: Arthroscopic stabilization using 8-mm Suretac fixators.
- Clinical outcomes assessed via Rowe and Constant scores, and range of motion (external rotation in abduction). Radiographic evaluation for drill-holes or cystic formations.
Main Results:
- No re-dislocations occurred in either group.
- Arthroscopic repair (Group B) demonstrated significantly better external rotation in abduction (83° vs. 65°, P=0.0017) and higher Constant scores (96 vs. 89, P=0.05).
- Radiographs showed more drill-holes or cystic formations in the open group (56% vs. 23%, P=0.002), associated with TAG anchors.
Conclusions:
- Arthroscopic Bankart reconstruction with Suretac fixators offers superior external rotation compared to open repair with TAG suture anchors.
- While radiographic changes were more frequent with open repair and TAG anchors, they did not appear to compromise the clinical outcome.
- Both techniques effectively addressed recurrent shoulder instability, but the arthroscopic approach may preserve range of motion better.