ARTHROSCOPIC BANKART REPAIR BY MATTRESS SUTURES WITH KNOTLESS ANCHORS FOR ANTERIOR SHOULDER INSTABILITY

Abstract

Background: Shoulder instability may be treated in a variety of ways, one of which is by arthroscopic stabilisation, also known as arthroscopic Bankart repair (ABR). While it is important to keep the capsulolabral tissue attached to the glenoid, tying a firm knot is a time-consuming and technically challenging process that might result in a premature locked tie or a failure to attain the necessary tension. On the other hand, a low-profile ancho may produce a great capsular shift while avoiding the time-consuming knot-tying process using a knotless suture anchor. Knotless anchors are often utilised presently because they provide a quick and stable method of labral fixation with good long-term results for patients suffering from shoulder instability.

Aim: To study the functional results and possible complications of Arthroscopic bankart repair by mattress sutures with knotless anchors for anterior shoulder instability.

Methods: Through the duration from (January) 2019 to (April) 2021, a prospective case series study was done, thirty patients were followed for a year after arthroscopic Bankart repair utilising mattress sutures with knotless anchors for traumatic repeated anterior shoulder instability in the absence of a substantial glenoid bone defect.

Results:  There was statistically significant improvement in the patients’ constant shoulder score which before surgery ranged from 52–68 with (mean 60.97±6.01), compared to after 1year ranged from 82–98 with (mean 90.10±5.38), this indicates a clear improvement of cases through constant shoulder score. Also, statistically significant improvement of the patients visual analogue score of pain which improved from 3–6 with (mean 4.30±1.21) to after 1year ranged from 0–2 with (mean 0.93±0.58) this indicates a clear reduction of pain in cases through VAS score. The patients American Shoulder and Elbow Surgeons Score improved from 31–55 with (mean 45.30±9.56) before surgery to after 1year ranged from 87–99 with (mean 93.47±4.08) this indicates a clear improvement of cases. In our study there was statistically insignificant decrease in External rotation which reduced by 6° at adduction and by 5° at 90° of abduction.

Conclusion: Arthroscopic bankart repair by mattress sutures with knotless anchors is a promising field for further studies that should have larger sample size and long term follow up of the patients. The principle is valid and may allow us of better bankart repair with reduced operative time which benefits the patient and surgeon