Kazutomo Miura1, Eiichi Tsuda2, Harukazu Tohyama3, Yusuke Iwahori4, Tatsuo Mae5, Yu Mochizuki6, Kohichi Nakagawa7, Atsuo Nakamae8, Toshiyasu Nakamura9, Masato Takao10, Sohshi Uchida11, Takeshi Muneta12, Mitsuo Ochi13. 1. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Rehabilitation Medicine, Hirosaki University, School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan. 2. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Rehabilitation Medicine, Hirosaki University, School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan. Electronic address: eiichi@hirosaki-u.ac.jp. 3. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo 060-0812, Japan. 4. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Aichi Medical University, School of Medicine, 1-1, Karimata, Yazakoaza, Oaza, Nagakute, Aichi 480-1195, Japan. 5. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871, Japan. 6. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedics Surgery, Hiroshima Prefectural Hospital, 1-5-54, Ujina-Kanda, Minami-ku, Hiroshima 734-8530, Japan. 7. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan. 8. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan. 9. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Sanno Hospital, 8-10-16 Akasaka, Minato-ku, Tokyo 107-0052, Japan. 10. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Clinical and Research Institute for Foot & Ankle Surgery, 341-1, Mangoku, Kisarazu, Chiba 292-0003, Japan. 11. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Wakamatsu Hospital for the University of Occupational and Environmental Health, 1-17-1 Hamamachi Wakamatsu Kitakyushu, Fukuoka 808-0024, Japan. 12. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. 13. Clinical Guidelines Committee, Japanese Orthopaedic Society of Knee, Arthroscopy, and Sports Medicine (JOSKAS) 5-1 Kojimachi, Chiyodaku, Tokyo 102-8481, Japan; Department of Orthopaedic Surgery, Division of Clinical Medical Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Abstract
BACKGROUND: Recently, arthroscopic Bankart repairs have become much more popular than open repairs for the treatment of recurrent anterior shoulder instability. However, it is unclear whether the modern arthroscopic Bankart repairs using suture anchors could restore equivalent stability to open repairs. We conducted a meta-analysis to compare arthroscopic Bankart repairs using suture anchors and open repairs in regard to clinical outcomes. METHODS: A literature review was performed according to the PRISMA guidelines. PubMed was searched from January 1966 to January 2017. Studies were identified using the terms 'anterior shoulder dislocation' or 'recurrent anterior shoulder dislocation' and 'Bankart repair'. The search yielded 36 publications. After reading the full-text articles, we included four randomized controlled trials and five retrospective studies that compared arthroscopic and open repairs using suture anchors. RESULTS: No significant differences were found between the two procedures in frank re-dislocation and revision surgery due to recurrence. However, the overall recurrent instability including not only re-dislocation but also subluxation and apprehension was significantly higher in arthroscopic repairs than in open repairs, while a significantly higher Rowe score and lower loss of external rotation at 90° of abduction were observed following arthroscopic repairs compared to open repairs. CONCLUSIONS: Modern arthroscopic Bankart repairs using suture anchors provide an equivalent outcome compared to open repairs in terms of apparent re-dislocation, but overall recurrent instability including subluxation or apprehension was still significantly higher in arthroscopic repairs than in open repairs.
BACKGROUND: Recently, arthroscopic Bankart repairs have become much more popular than open repairs for the treatment of recurrent anterior shoulder instability. However, it is unclear whether the modern arthroscopic Bankart repairs using suture anchors could restore equivalent stability to open repairs. We conducted a meta-analysis to compare arthroscopic Bankart repairs using suture anchors and open repairs in regard to clinical outcomes. METHODS: A literature review was performed according to the PRISMA guidelines. PubMed was searched from January 1966 to January 2017. Studies were identified using the terms 'anterior shoulder dislocation' or 'recurrent anterior shoulder dislocation' and 'Bankart repair'. The search yielded 36 publications. After reading the full-text articles, we included four randomized controlled trials and five retrospective studies that compared arthroscopic and open repairs using suture anchors. RESULTS: No significant differences were found between the two procedures in frank re-dislocation and revision surgery due to recurrence. However, the overall recurrent instability including not only re-dislocation but also subluxation and apprehension was significantly higher in arthroscopic repairs than in open repairs, while a significantly higher Rowe score and lower loss of external rotation at 90° of abduction were observed following arthroscopic repairs compared to open repairs. CONCLUSIONS: Modern arthroscopic Bankart repairs using suture anchors provide an equivalent outcome compared to open repairs in terms of apparent re-dislocation, but overall recurrent instability including subluxation or apprehension was still significantly higher in arthroscopic repairs than in open repairs.
Authors: Juha Kukkonen; Sami Elamo; Tapio Flinkkilä; Juha Paloneva; Miia Mäntysaari; Antti Joukainen; Janne Lehtinen; Vesa Lepola; Milja Holstila; Tommi Kauko; Ville Aarimaa Journal: Br J Sports Med Date: 2021-09-22 Impact factor: 13.800