Arthroscopic shoulder stabilization using Mitek anchors

Abstract

The purpose of this paper is to report our experience with an arthroscopic stabilization technique using bone anchors in the treatment of chronic unidirectional anterior-inferior shoulder instability. 30 of 32 patients (average age, 26 years) were followed for an average of 24 months (range 12 to 36). There were 28 patients with dislocations and four with subluxations. In the group of the dislocators five patients had more than 10 dislocations and 15 patients between one and seven (average three). In 68% a sport injury was the reason for the first dislocation. Due to the length of the labroligamentous detachment two to four anchors were used for stabilization. According to the criteria of Rowe, in the group of the subluxators (4) two had an excellent and two a good result. In the group of the dislocators (26) two patients dislocated their shoulder again after reconstruction without a new accident, one had a recurrent dislocation from significant trauma. Two of them had an open stabilization afterwards. Overall there were 53.9% excellent, 34.6% good and 11.5% poor results. In 50% there was no restriction of shoulder motion, 21% had a loss of external rotation of 5 degrees and 29% of 10 degrees. Arthroscopic shoulder stabilization with help of Mitek anchors seems to be a good method for treatment of chronic unidirectional anterior-inferior instabilities with less than 10 dislocations preoperatively. All patients, who suffered a spontaneous recurrent dislocation, had more than 10 dislocations before. In these cases this arthroscopic procedure is not suited to restore stability, even if a Bankart-lesion is present.

Shoulder Instability: Management and Rehabilitation

“…However, arthroscopic procedures are associated with less loss in external rotation than open procedures. Arthroscopic techniques for reattaching the labrum can be divided into three categories: (1) a transglenoid suture technique, 14,26,35,51,62,74,76 (2) arthroscopically delivered and tied suture anchors, 33,40,93 and (3) arthroscopically delivered biodegradable tacs. 4,12,25,26,28,51,52,86,92 A comparison of the reported rates of recurrent dislocation for each technique is made in the Table. Multidirectional Instability The most commonly performed and most successfully reported surgical procedure for multidirectional instability of the shoulder is an anterior capsular shift, an open procedure that involves the overlaying and thus shortening of the anterior and inferior capsule.…”

Die arthroskopische Bankart-Operation mit Hilfe von resorbierbaren Nahtankern

“…1987 veröffentlichten Morgan & Bodenstab eine arthroskopische transglenoidale Nahttechnik [16]. Seit dieser Zeit wurde eine Vielzahl von arthroskopischen Techniken unter Verwendung von Schrauben, Nahtankern und Dübeln beschrieben [10,12,19,24,25]. Nachfolgend wird eine arthroskopische Technik zur Schulterstabilisation mit resorbierbaren Nahtankern (Panalok, DePuy Mitek Ethicon, Norderstedt) vorgestellt.…”

“…Steinbeck & Jerosch [22] 1998 Arthroskopische transglenoidale Stabilisation 30 83,1 57 23 3 17 Resch et al [20] 1997 Arthroskopische extraartikuläre 318 74 9 8 9 Bankart-Operation Hoffmann & Reif [10] 1995 Arthroskopische Bankart-Operation 30 53,9 34,6 11,5 mit Mitek-Ankern Arciero et al [1] 1995 Arthroskopische Stabilisation mit einem 19 95 84,2 10,5 5,3 resorbierbaren Dübel Grana et al [8] 1993 [6,14,15]. Auch bei arthroskopischen Nahttechniken wurden bei gleicher Technik Reluxationsraten zwischen 4% und 49% angegeben [5,23].…”

“…In 1987, Morgan & Bodenstab published an arthroscopic transglenoidal suture technique [16]. Since that time, a number of arthroscopic techniques have been described using screws, suture anchors and dowels [10,12,19,24,25]. An arthroscopic shoulder stabilization technique has subsequently been introduced using resorbable suture anchors (Panalok, DePuy Mitek Ethicon, Norderstedt, Germany).…”

Die arthroskopische Labrumrefixation bei vorderer Schulterinstabilität

“…Wolf (43) konnte in seinem Patientengut keine Reluxationen feststellen. Hoffmann (14) fand bei 30 Patienten eine Reluxationsrate von 10%. Speck (37) stellte bei einem 24-monatigem Nachbeobachtungszeitraum bei 4 seiner 30 Patienten (12,3%) eine Reluxation fest.…”