Assessments of activities of daily living after arthroscopic SLAP repair with knot-tying versus knotless suture anchors

Reinig, Y.; Welsch, F.; Hoffmann, Reinhard; Müller, Daniel; Gramlich, S; Fischer, Sebastian; Schüttler, Karl F.; Zimmermann, Elke; Stein, Thomas

doi:10.1007/s00402-019-03151-5

Cited by 6 publications

(8 citation statements)

References 53 publications

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“…Prior studies on unplanned reoperation after SLAP repair report a wide range of reoperation rates [1–4, 6, 7, 10–12, 16, 18, 19]. These wide ranges are attributed to patient factors (E.g.…”

Section: Discussionmentioning

confidence: 99%

“…This wide discrepancy is likely the result of multiple factors contributing to outcomes, including patient characteristics (E.g. age, smoking or worker’s compensation) [1, 2, 10, 11, 16, 19], heterogenous or concomitant injuries [16], variability in indications [10, 17, 18], and many different types of repair techniques [12, 15]. For example, some studies include only isolated type II SLAP repairs [7, 11], while others include patients with additional shoulder procedures with comorbid shoulder pathology [16, 17].…”

Section: Introductionmentioning

confidence: 99%

“…The rate of reoperation after superior labrum anterior and posterior (SLAP) repair ranges between 2.5–28% [1–4, 6, 7, 10–12, 16, 18, 19]. This wide discrepancy is likely the result of multiple factors contributing to outcomes, including patient characteristics (E.g.…”

Section: Introductionmentioning

confidence: 99%

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Isolated type II SLAP tears undergo reoperation more frequently

Defazio

Özkan

Wagner

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose There is discrepancy in the reported reoperation rate and factors associated with reoperation after type II SLAP repair. The aim was to determine the incidence and factors associated with unplanned reoperation and repair failure after type II SLAP repair. Methods Five-hundred and thiry-nine patients with SLAP repairs were identifiedfrom 2005 to 2016. Patient characteristics were recorded and subgroup analyses performed. Multivariable logistic regression was used to identify factors independently associated with unplanned reoperation and SLAP repair failure. Results Sixty-six of 539 patients (12%) had unplanned reoperation after SLAP repair. Additional procedures during SLAP repair were associated with fewer unplanned reoperations (OR 0.57; P = 0.046). Age < 40 was associated with unplanned reoperation (55% vs 40%; P = 0.032), but this was not an independent association. Forty-five of 539 patients (8.3%) had SLAP repair failure (defined by repeat SLAP repair or biceps tenodesis/tenotomy). Smoking (OR 3.1; P = 0.004) and knotless suture anchors (OR 3.4; P = 0.007) were associated with SLAP repair failure. Isolated SLAP repair was associated with SLAP repair failure (64% vs 46%; P = 0.020), but this was not an independent association. In those who did not have an isolated SLAP repair, knotless suture anchors (19% vs 3.4%; P = 0.024) were associated with repair failure. Conclusion After type II SLAP repair, roughly 1 in 10 patients may undergo reoperation. Isolated SLAP repair is independently associated with unplanned reoperation. Level of evidence Level III.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Isolated type II SLAP tears undergo reoperation more frequently

Defazio

Özkan

Wagner

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…22,25,73 These techniques are used for Bankart and superior labrum from anterior to posterior (SLAP) tear repair in shoulder arthroscopic surgery, in which knotless anchor technology has shown favorable results. 52,61 However, Safran et al 66 recently reported their results after comparing the biomechanics of different knotless anchor models. The exact physiological loads on hip labral repair are unknown, making it difficult to evaluate the superiority of one anchor over another in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…20,69 In shoulder arthroscopic surgery, knotless anchor technology has been implemented, with comparable results to the knot-tying alternative. 22,61 Moreover, it has the potential benefits of avoiding knot-tying difficulty and avoiding pain due to knot space occupation irritating surrounding tissue or due to potential articular abrasion. 2 Although these principles have been adopted in hip arthroscopic surgery, biomechanical requirements may not be the same between shoulder and acetabular labral repair.…”

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confidence: 99%

Prospective Analysis of Arthroscopic Hip Anatomic Labral Repair Utilizing Knotless Suture Anchor Technology: The Controlled-Tension Anatomic Technique at Minimum 2-Year Follow-up

Maldonado

Chen

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Labral tears are the most common abnormalities in patients undergoing hip arthroscopic surgery. Appropriate management is crucial, as it has been shown that better overall outcomes can be achieved with labral restoration. Purpose: To report the patient-reported outcomes (PROs) at minimum 2-year follow-up of patients who underwent hip arthroscopic surgery for labral tear repair using the knotless controlled-tension anatomic technique in the setting of femoroacetabular impingement syndrome (FAIS). Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected for patients who underwent hip arthroscopic surgery for FAIS for labral tear repair using the knotless controlled-tension anatomic technique. Patients were excluded if they had prior hip conditions, prior ipsilateral surgery, Tönnis grade >1, a lateral center-edge angle (LCEA) <25°, or workers’ compensation claims. Preoperative and postoperative scores at minimum 2-year follow-up were recorded for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain. The proportion of patients who achieved the minimal clinically important difference (MCID) or patient acceptable symptomatic state (PASS) for the mHHS, HOS-SSS, and iHOT-12 were also reported. Results: A total of 309 hips were included. The mean patient age was 36.2 years (range, 12.8-75.9 years). The mean preoperative LCEA and alpha angle were 31.9° and 57.1°, respectively. A significant improvement on the mHHS (62.6 ± 15.7 preoperatively vs 86.9 ± 16.2 at 2-year follow-up), NAHS (63.1 ± 16.7 vs 86.1 ± 16.7), and HOS-SSS (39.8 ± 22.0 vs 74.2 ± 27.3) was found ( P < .001 for all). A significant decrease was shown for VAS scores ( P < .001). Also, 78.6% and 82.2% of patients achieved the MCID and PASS for the mHHS, respectively; 60.8% and 69.9% of patients met the MCID and PASS for the HOS-SSS, respectively; and the MCID for the iHOT-12 was met by 77.3% of patients. Conclusion: In the setting of FAIS and labral tears, patients who underwent hip arthroscopic surgery for labral tear repair using the knotless controlled-tension anatomic technique demonstrated significant improvement in several validated PRO measures, the VAS pain score, and patient satisfaction at a minimum 2 years of follow-up. Based on this evidence, labral tear repair using the knotless controlled-tension anatomic technique seems to be a safe option.

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