Arthroscopic SLAP IIb Repair Using Knot-Tying Versus Knotless Suture Anchors: Is There a Difference?

S Joseph de Groot, Justin W Arner, Clair N Smith, James P Bradley
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Abstract

The use of knotless suture anchors has increased in popularity; however, there is a paucity of literature examining the difference in clinical outcomes with traditional knotted fixation. It was hypothesized that knotless fixation would provide superior clinical outcomes, improved return to play (RTP), and lower revision rates as compared with traditional knotted fixation in the repair of SLAP IIb tears. Seventy-four athletes who underwent arthroscopic SLAP IIb repair with traditional (n = 42) and knotless anchors (n = 32) by a single surgeon were evaluated after a minimum 2-year follow. Demographic and surgical data, RTP, Kerlan-Jobe Orthopaedic Clinic (KJOC) score, American Shoulder and Elbow Surgeons (ASES) score, stability, strength, and pain scores were compared. Knotless anchors had slightly higher RTP (93.5% vs 90.2%, P = .94) and RTP at the same level (58.1% vs 53.7% P = .81) compared with knotted fixation, but the difference did not reach statistical significance. Knotless anchors were less likely to require revision surgery than traditional anchors (9% vs 17%, P = .50), but the difference was not statistically significant. When comparing knotless and traditional knotted suture anchor repair of type llb SLAP tears, knotless fixation required less revision surgery and had higher RTP, ASES, and KJOC scores; however, statistical significance was not achieved in this relatively small cohort.

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关节镜下使用打结与无打结缝合锚钉修复SLAP IIb:有区别吗?
无结缝合锚钉的使用越来越普及;然而,关于传统打结固定在临床结果上的差异的文献很少。假设与传统的打结固定相比,无结固定可以提供更好的临床结果,改善比赛恢复(RTP),并且在修复SLAP IIb撕裂时降低翻修率。74名运动员在至少2年的随访后接受了由一名外科医生使用传统(n = 42)和无结锚(n = 32)进行的关节镜SLAP IIb修复。比较了人口统计学和外科数据、RTP、Kerlan-Jobe Orthopaedic Clinic (KJOC)评分、American Shoulder and肘部外科医生(ASES)评分、稳定性、力量和疼痛评分。无节锚钉的RTP (93.5% vs 90.2%, P = 0.94)和RTP (58.1% vs 53.7% P = 0.81)略高于有节固定,但差异无统计学意义。与传统锚钉相比,无节锚钉需要翻修手术的可能性更小(9% vs 17%, P = 0.50),但差异无统计学意义。在比较无结和传统打结缝合锚定修复llb型SLAP撕裂时,无结固定所需翻修手术较少,RTP、ASES和KJOC评分较高;然而,在这个相对较小的队列中,没有达到统计学意义。
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