PMID- 36932219
OWN - NLM
STAT- MEDLINE
DCOM- 20230410
LR  - 20230524
IS  - 1432-5195 (Electronic)
IS  - 0341-2695 (Linking)
VI  - 47
IP  - 5
DP  - 2023 May
TI  - Arthroscopic Bankart repair: how many knotless anchors do we need for anatomic 
      reconstruction of the shoulder?-a prospective randomized controlled study.
PG  - 1285-1293
LID - 10.1007/s00264-023-05749-2 [doi]
AB  - PURPOSE: The optimal strategy for surgical repair of traumatic anterior shoulder 
      instability remains controversial. While several study groups have reported that 
      the clinical and radiological outcomes of arthroscopic procedures performed with 
      two anchors are not fully adequate, these conclusions are not supported by the 
      findings published in other studies. A prospective randomized study was conducted 
      to compare the structural and clinical outcomes of surgical procedures involving 
      two vs. three anchors. METHODS: Patients who underwent arthroscopic Bankart 
      repair were randomly assigned to either Group I, which underwent procedures 
      involving two double-loaded 3.5-mm knotless anchors, or Group II, which underwent 
      procedures involving three single-loaded 2.9-mm knotless anchors. All patients 
      underwent bilateral MRI assessments at a minimum of 12 months and clinical 
      assessment at a minimum of 24 months postoperatively. To evaluate the 
      reconstruction of the labral capsular ligamentous complex (LCLC), the 
      labrum-glenoid height index (LGHI), restored labral height (LH), and labral slope 
      (LS) were measured for both shoulders. For clinical assessment, the redislocation 
      rate and functional outcome scores (Constant score (CS), American Shoulder and 
      Elbow Surgeon score (ASES), Walch Duplay score (WDS), and Rowe score (RS)) were 
      evaluated at follow-up visits. RESULTS: Bankart repair with two knotless anchors 
      showed lower values for anterior reconstruction of the LCLC compared to the 
      uninjured contralateral shoulder. Likewise, significant differences were noted 
      when comparing these measurements to those from patients who underwent 
      reconstruction with three anchors. No differences were demonstrated with regard 
      to the reconstruction of the inferior LCLC. Clinical assessment showed good to 
      excellent results in both groups. In total, three patients experienced 
      redislocation of the shoulder: two in group I and one in group II. No significant 
      differences were found with respect to clinical outcomes and redislocation rates. 
      CONCLUSION: Bankart repair with both two and three knotless anchors results in 
      effective anatomical reconstruction of the labral capsular ligamentous complex. 
      Although the two-anchor technique yields significantly lower values for the 
      anterior portion compared with the contralateral side, none of these differences 
      reach clinical relevance as per our original definition.
CI  - (c) 2023. The Author(s) under exclusive licence to SICOT aisbl.
FAU - Buckup, Johannes
AU  - Buckup J
AUID- ORCID: 0000-0003-4815-7026
AD  - Department of Sports Traumatology, Knee and Shoulder Surgery, 
      Berufsgenossenschaftliche Unfallklinik Frankfurt Am Main, Frankfurt, Germany. 
      buckup@me.com.
AD  - Department for Shoulder Surgery and Sports Medicine, ATOS Klinik Frankfurt Am 
      Main, Frankfurt, Germany. buckup@me.com.
FAU - Welsch, Frederic
AU  - Welsch F
AD  - Department of Sports Traumatology, Knee and Shoulder Surgery, 
      Berufsgenossenschaftliche Unfallklinik Frankfurt Am Main, Frankfurt, Germany.
FAU - Petchennik, Stanislav
AU  - Petchennik S
AD  - Department of Orthopaedic Surgery and Arthroplasty, Vitos Orthopaedic Clinic 
      Kassel, Kassel, Germany.
FAU - Klug, Alexander
AU  - Klug A
AD  - Department of Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche 
      Unfallklinik Frankfurt Am Main, Frankfurt Am Main, Germany.
FAU - Gramlich, Yves
AU  - Gramlich Y
AD  - Department of Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche 
      Unfallklinik Frankfurt Am Main, Frankfurt Am Main, Germany.
FAU - Hoffmann, Reinhard
AU  - Hoffmann R
AD  - Department of Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche 
      Unfallklinik Frankfurt Am Main, Frankfurt Am Main, Germany.
FAU - Stein, Thomas
AU  - Stein T
AD  - SPORTHOLOGICUM Frankfurt, Medical Center for Sport and Joint Injuries, Frankfurt 
      Am Main, Germany.
AD  - Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt, Germany.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20230317
PL  - Germany
TA  - Int Orthop
JT  - International orthopaedics
JID - 7705431
SB  - IM
MH  - Humans
MH  - *Shoulder Dislocation/surgery
MH  - *Shoulder Joint/diagnostic imaging/surgery
MH  - Shoulder
MH  - *Joint Instability/surgery
MH  - Prospective Studies
MH  - Arthroscopy/methods
MH  - Suture Anchors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Bankart repair
OT  - Labrum
OT  - Shoulder
OT  - Suture anchor
EDAT- 2023/03/19 06:00
MHDA- 2023/04/10 06:42
CRDT- 2023/03/18 00:23
PHST- 2022/11/15 00:00 [received]
PHST- 2023/02/25 00:00 [accepted]
PHST- 2023/04/10 06:42 [medline]
PHST- 2023/03/19 06:00 [pubmed]
PHST- 2023/03/18 00:23 [entrez]
AID - 10.1007/s00264-023-05749-2 [pii]
AID - 10.1007/s00264-023-05749-2 [doi]
PST - ppublish
SO  - Int Orthop. 2023 May;47(5):1285-1293. doi: 10.1007/s00264-023-05749-2. Epub 2023 
      Mar 17.