Arthroscopic Stabilization of Recurrent Anterior Shoulder Instability Using Two Anchors, One Single Loaded plus One Double-Loaded; a Prospective Study with Modified Technique

Objectives: Anterior shoulder instability with minimal glenoid bone loss has several options fo r Bankart repair. We aimed to evaluate the results of a modified technique using two anchors with double and single loaded suture (three stitches in total) in arthroscopic Bankart surgery.Methods: Thirty-eight patients underwent arthroscopic Bankart surgery and were assessed after an average ۴۰ months follow-up. They underwent two-anchor repairs with single loaded of a high-strength, non-absorbable braided suture and double loaded suture. The participants were assessed preoperatively and postoperatively in terms of range of motion, CONSTANT Scores, and visual analogue scale (VAS). Recurrence of subluxations, dislocations, and other complications were also assessed.Results: The mean follow-up time was ۴۰.۱±۶.۹۹ months. The mean Constant scores were ۸۰.۳۲±۴.۸۱ (۹۵%CI: ۷۸.۷۳-۸۱.۹۰) preoperatively and ۹۴.۴۵±۳.۷۱ (۹۵%CI: ۹۳.۲۳-۹۵.۶۷) postoperatively (P = < ۰.۰۰۱). A significant change was noted for the VAS score from ۲.۷۴±۰.۹۵ (۹۵%CI: ۲.۴۲-۳.۰۵) to ۰.۶۳±۰.۷۵ (۹۵%CI: ۰.۳۸-۰.۸۸) (P < ۰.۰۰۱). Mean preoperative external rotation and forward flexion were also preserved postoperatively (P < ۰.۰۰۱). The incidence of nonclinical subluxation was ۲/۳۸, ۵.۳%, however no case of clinical subluxation or re-dislocation was occurred; infection or neurovascular complications have not been observed as well.Conclusion: Using two anchors with single and double loaded arthroscopic suture showed acceptable clinical results for traumatic anterior shoulder instability repair in properly selected patients. Level of evidence: IV

Keywords:

Anterior shoulder instability , Arthroscopy , Bankart lesion , Suture anchors