Comparison of Clinical and Functional Results after Arthroscopic Bankart Repair with the All-Soft Suture Anchor and the Conventional Metal Anchor

Abstract

Aim: To compare the clinical results after arthroscopic bankart repair with all-soft suture anchor and conventionalmetal anchor in physically active patients with traumatic anterior shoulder instability.Material and Methods: A total of 32 patients who met eligibility criteria were included between 2016 and 2017 years,for arthroscopic bankart repair in a single orthopedic department. The patients were examined into 2 groups as 17underwent repair with 1.8 mm all-suture anchor with 2 (5 metric) Hi-Fi® sutures (Y-knot® flex, Conmed, USA) (group1), and 15 underwent repair with conventional titanium 3.5 mm Suture Anchors with two preloaded ultrabraid sutures(TWINFIX, Smith & Nephew) (group 2). Clinical and functional outcomes were assessed pretreatment, and finalfollow-up using the American shoulder and Elbow surgeons (ASES) score and the ROWE score.Results: The mean ASES score increased significantly in group 1 from 35.62±8.46 to 88.86±6.23 (p=0.0001) and hadincreased significantly in group 2 from 41.15±14.51 to 91.15±7.54 (p=0.0001). The mean ROWE score had increasedsignificantly in group 1 from 48.82±11.25 to 85.00±10.00 (p=0.0001) and had significantly increased in group 2 from45.67±9.61 to 87.67±10.15 (p=0.0001). There was no significant difference between the mean ASES scores of group 1and group 2 (p=0.192, p=0.353), and also no significant difference between the mean ROWE scores of group 1 andgroup 2 (p=0.404, p=0.461) at pretreatment and final follow-up respectively.Conclusion: Arthroscopic bankart repair with an all-soft suture anchor demonstrated comparable clinical and functionalresults as the conventional metal suture anchor at short term follow-up.Amaç: Travmatik anterior omuz instabilitesi olan fiziksel olarak aktif hastalarda tüm yumuşak sütür ankor ve konvansiyonel metal ankor ile artroskopik bankart tamirinin klinik ve fonksiyonel sonuçlarının kıyaslanması amaçlanmıştır. Gereç ve Yöntemler: 2016-2017 yılları arasında, tek merkezde artroskopik bankart tamiri yapılan ve dahil edilme kriterlerimize uyan 32 hasta değerlendirildi. 17 hastaya 1.8 mm (Y-knot® flex, Conmed, USA) tüm yumuşak sütür ankor (grup 1) ve 15 hastaya ise 3.5 mm (TWINFIX, Smith & Nephew) konvansiyonel metal ankor (grup 2) uygulandı. Klinik ve fonksiyonel sonuçlar tedaviden hemen önce ve son takipte Amerikan omuz ve Dirsek cerrahları (ASES) skoru ve ROWE skoru ile değerlendirildi. Bulgular: Ortalama ASES skoru grup 1’de 35.62±8.46'dan 88.86±6.23'e (p=0.0001) ve grup 2’de ise 41.15±14.51’den 91.15±7.54’e (p=0.0001) artmıştır. Ortalama ROWE skoru da grup 1’de 48.82±11.25'ten 85.00±10.00'a (p=0.0001) ve grup 2’de ise 45.67±9.61’den 87.67±10.15’e (p=0.0001) yükseldi. Grup 1 ve grup 2’nin tedavi öncesi ve son takibinde ortalama ASES ve ROWE skorlarında fark yoktur (p=0.192, p=0.353 ve p=0.404, p=0.461). Sonuç: Tüm yumuşak sütür ankor ile artroskopik bankart tamiri, kısa süreli takipte konvansiyonel metal sütür ankor ile karşılaştırılabilir klinik ve fonksiyonel sonuçlar göstermiştir