Arthroscopic Bankart repair using trans-glenoid double-loaded grand knots versus double-loaded suture anchors; is there a difference? a randomized controlled study.

Abstract

Background: Anatomical repair of Bankart lesions and restoring the tension of the antero-inferior capsulo-labral complex is the optimum method of surgical treatment with a variety of fixation methods including suture anchors and trans-glenoid sutures. Grand knot technique is a modification of the trans-glenoid sutures technique that can be an alternative to double-loaded suture anchors with a lower cost. We aimed to compare the outcomes and complications of both techniques.

Methods: This is a randomized controlled study that was conducted on 200 patients with recurrent anterior glenohumeral dislocation, of whom 170 patients completed at least a three-year follow-up period. Arthroscopic Bankart repair using two double-loaded knotted suture anchors was performed in 78 cases (Group A) while repair was done using two trans-glenoid grand knots in other 92 cases (Group B). Patients were evaluated in terms of range of motion, functional scores (Constant, Rowe, and ASES), and complication rate.

Results: The mean operative time was significantly longer in Group B (87.7 ± 24) minutes compared to Group A (61.2 ± 28.1) minutes (P = 0.002). No statistically significant difference was found between both groups regarding postoperative external rotation range of adducted arm, functional scores, and rate of recurrence. Only forward flexion and external rotation of abducted arm were significantly better in Group A (P = 0.005 and < 0.001 respectively).

Conclusion: Trans-glenoid double-loaded grand knot technique is an alternative surgical option for the treatment of Bankart lesions with comparable results to double-loaded anchors regarding the functional outcomes and failure rates.

Clinical trial registration (retrospectively registered): Registration number: NCT06394609 28-4-2024.