Comparison of Clinical Outcomes and Computed Tomography Analysis for Tunnel Diameter After Arthroscopic Bankart Repair With the All-Suture Anchor and the Biodegradable Suture Anchor

Abstract

To compare the clinical outcomes and radiological findings at the anchor site after arthroscopic Bankart repair with all-suture anchors and biodegradable suture anchors in patients with recurrent anterior shoulder dislocation. The patients who underwent arthroscopic Bankart repair were divided into 2 groups depending on the type of the suture anchor used in different periods. Power analysis was designed based on the postoperative Rowe score. Clinical outcomes, including the Rowe score, American Shoulder and Elbow Surgeons score, subjective instability, and redislocation rates were evaluated. In all patients enrolled, the tunnel diameter of the anchor was assessed with computed tomography arthrogram at 1year postoperatively. The Institutional Review Board of Ewha Womans University approved this study (no. EUMC 2017-05-058). A total of 67 patients were enrolled: 33 underwent surgery with a 1.3-mm (single-loaded) or 1.8-mm (double-loaded) all-suture anchor (group A), and 34 underwent surgery with a 3.0-mm biodegradable anchor (10.8mm in length, 30% 1,2,3-trichloropropane/70% poly-lactide-co-glycolic acid) (group B). There were no significant differences in clinical outcomes between groups A and B in the American Shoulder and Elbow Surgeons score (preoperatively, 51.2 ± 13.7 vs 47.7 ± 12.2; 2years postoperatively, 88.5 ± 12.3 vs 89.7 ± 10.9; P= .667) and Rowe score (preoperatively, 41.4 ± 10.5 vs 41.3 ± 9.4; 2years postoperatively, 87.9 ± 14.9 vs 88.5 ± 14.6; P= .857). Postoperative redislocation (6.1% vs 5.9%, P= .682) and subjective instability rate (12.2% vs 17.7%, P= .386) of both groups showed no significant difference. Average tunnel diameter increment was significantly greater with the 1.8-mm all-suture anchor (2.8 ± 0.9mm) than the 1.3-mm all-suture anchor (1.2 ± 0.8mm) and 3.0-mm biodegradable anchor (0.8 ± 1.2mm)(P < .001). Arthroscopic Bankart repair with the all-suture anchor showed comparable clinical outcomes and postoperative stability as the conventional biodegradable suture anchor at 2years after surgery. Tunnel diameter increment of the all-suture anchor was significantly greater than that of the biodegradable suture anchor at the 1-year computed tomography analysis. Although tunnel diameter increment was greater with the all-suture anchor, it did not influence the clinical outcomes. Level III, retrospective comparative study.