F. Kandziora et al., Arthroscopic labrum refixation for post-traumatic anterior shoulder instability: Suture anchor versus transglenoid fixation technique, ARTHROSCOPY, 16(4), 2000, pp. 359-366
The aim of this retrospective study was to compare recurrence rates followi
ng transglenoid labrum refixation or fixation using the suture anchor (FAST
ak, Arthrex, Naples, FL) technique. Additionally parameters that apparently
influence the rate of redislocation were investigated. There were 183 pati
ents with post-traumatic anterior shoulder instability treated with an arth
roscopic labrum refixation; 108 patients (66.3%) were stabilized with the t
ransglenoid suture technique (group I) and 55 patients (33.7%) with the sut
ure anchor (FASTak) technique (group II). The average follow-up was 4.5 yea
rs (range, 2.0 to 7.9 years) in group I and 3.2 years (range, 2.0 to 5.0 ye
ars) in group II. The Rowe score increased from a preoperative average of 3
5.0 points in group I and 35.4 points in group II to a postoperative averag
e of 68.3 points in group I and 84.6 points in group II (P < .01), There wa
s recurrence in 35 patients (32.4%) in group I and 9 patients (16.4%) in gr
oup II (P < .05), All incidents of redislocation occurred during the first
21 postoperative months; 58.4% of the patients (n = 63) in group I and 16.4
% of the patients in group II (n = 9) had to reduce their sporting activity
(P < .001). Independent of the type of surgery, there was a significant co
rrelation of the postoperative rate of redislocation and age (P < .001), nu
mber of preoperative dislocations (P < .01), and degree of labrum lesion (P
< .001). No correlation with the rate of redislocation was shown for gende
r, handedness, dislocation-operation interval, degree of Hill-Sachs lesion,
or number of transglenoid sutures or anchors. Concerning post-traumatic an
terior shoulder instability, the arthroscopic labrum reconstruction with th
e suture anchor (FASTak) technique was superior to the transglenoid techniq
ue but has not yet achieved the level of success obtained by open surgery.
With fewer than 5 preoperative redislocations after a first traumatic shoul
der dislocation, the arthroscopic treatment is recommended. In cases of mor
e frequent preoperative dislocations, open surgery in combination with a ca
psular shift should be performed.