Abstract
Background:Over the last 2 decades arthroscopic stabilization and Bankart repair has gained popularity due to the advances in materials and surgical techniques. Results of arthroscopic stabilization have been similar to open without the risks of it. The number of anchors used has been suggested to be very important in “spot-weld” arthroscopic stabilization however the “purse-string” technique (PST) can achieve similar results using only one anchor.We describe technique and long term results from using the PST and search the literature for other papers regarding PST.Methods:Between 2003 and 2013 a total of 193 patients were operated. Patients included those with anterior instability. Using PubMed relevant studies reporting results of PST were identified.Results:Mean follow up was 2 (range 0.5 to 3) years. 9 (4.7%) patients experienced recurrent instability. Almost all patients (97%) returned to their sporting and leisure activities and all professional athletes went back to the same sport. One more UK centre reported 6.1% recurrence in 114 patients at 4 years follow up. These results are similar to the published 11% recurrence of instability after “spot-weld” arthroscopic techniques at 11 years clinical follow-up.Conclusion:This study indicates that PST is safe and effective alternative method for the treatment of anterior shoulder instability. In this technique with one anchor simultaneous repair of labrum, creation of an anterior bumper and capsular shift can be achieved. It has the advantage of being cheaper, faster yet efficient with good long term results and leaves space for revision anchors in case of recurrence.
Highlights
Repair of avulsion of the anterior inferior labrum from the glenoid rim that was first described in 1920 by Bankart [1] and earlier by Perthes [2] can be either open or arthroscopic
This study indicates that purse-string” technique (PST) is safe and effective alternative method for the treatment of anterior shoulder instability
Over the last years arthroscopic surgery has made significant advances both in materials and techniques. This has led to similar long term results between open and arthroscopic surgery for anterior shoulder instability [12, 13]
Summary
Repair of avulsion of the anterior inferior labrum from the glenoid rim that was first described in 1920 by Bankart [1] and earlier by Perthes [2] can be either open or arthroscopic. Arthroscopic repair is performed using multiple suture anchors and a minimum of 3 anchors is perceived to be necessary to achieve optimum results restoring the labral “bumper”. Copeland [7] in the form of “purse- string” technique was first described in 2006 by O. Since one more centre has published results using the “purse- string” technique to achieve successful arthroscopic shoulder stabilization [10]. Over the last 2 decades arthroscopic stabilization and Bankart repair has gained popularity due to the advances in materials and surgical techniques. Results of arthroscopic stabilization have been similar to open without the risks of it. The number of anchors used has been suggested to be very important in “spot-weld” arthroscopic stabilization the “purse-string” technique (PST) can achieve similar results using only one anchor.
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