Our Summary

This research paper looks at whether there’s any significant difference in results when using two types of anchors - knotless and knotted - in shoulder surgery. The specific types of shoulder surgery looked at are Bankart repair, SLAP repair, and posterior labral repair.

The researchers reviewed 17 previous studies on the topic. When it came to the physical outcomes of the surgery, the results were mixed. Five studies found no major differences between the two types of anchors in Bankart repair. One study found knotless anchors to be better for SLAP repair, and two studies found no major differences in remplissage (a specific type of Bankart repair).

When looking at patient outcomes, four studies found no significant differences between the two types of anchors in Bankart repair, although one study found that knotted anchors led to better patient feedback and less need for follow-up surgery. Five studies found no major differences between the two in SLAP repair.

Interestingly, in terms of the time taken for surgery, four out of five studies found that surgeries were quicker when knotless anchors were used.

In conclusion, the research found no major differences between the two types of anchors in terms of patient outcomes. However, the evidence is not clear cut when it comes to the physical outcomes of the surgery. Also, surgeries might be quicker with knotless anchors.

FAQs

  1. Does the type of anchor used in shoulder surgeries like Bankart repair, SLAP repair, and posterior labral repair significantly affect patient outcomes?
  2. According to the research, are surgeries quicker when knotless anchors are used instead of knotted ones?
  3. Is there a clear consensus on which type of anchor - knotted or knotless - leads to better physical outcomes post-surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about labral repair using anchors is that while there may not be significant differences in patient outcomes between knotless and knotted anchors, surgeries may be quicker when using knotless anchors. It is important to discuss the options with your surgeon and weigh the potential benefits and drawbacks of each type of anchor before making a decision.

Suitable For

Labral repair is typically recommended for patients who have experienced shoulder instability or dislocations due to a torn labrum. This can include athletes who participate in overhead sports, individuals with repetitive shoulder injuries, or those with underlying shoulder conditions such as shoulder impingement syndrome. Patients who have persistent shoulder pain, weakness, or limited range of motion may also be recommended for labral repair surgery. Additionally, patients who have failed to respond to non-surgical treatments such as physical therapy or corticosteroid injections may be candidates for labral repair. It is important for patients to consult with a qualified orthopedic surgeon to determine if labral repair is the best course of action for their specific condition.

Timeline

Before labral repair surgery, a patient typically experiences shoulder pain, instability, weakness, and limited range of motion. They may undergo physical therapy, cortisone injections, and other conservative treatments before deciding to undergo surgery.

After labral repair surgery, the patient will go through a period of rehabilitation and physical therapy to regain strength and range of motion in the shoulder. This process can take several months, with gradual progress being made over time. The patient may also experience some pain and discomfort during the initial stages of recovery.

Overall, the goal of labral repair surgery is to improve shoulder function and reduce pain, allowing the patient to return to their normal activities and sports. With proper rehabilitation and follow-up care, most patients are able to achieve a successful outcome and resume their normal daily activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about labral repair using knotless or knotted anchors include:

  1. What specific type of labral repair surgery will be performed (Bankart repair, SLAP repair, posterior labral repair)?
  2. What type of anchors will be used in the surgery - knotless or knotted?
  3. What are the potential risks and benefits associated with each type of anchor?
  4. Are there any differences in post-operative recovery time between knotless and knotted anchors?
  5. What is the success rate of labral repair using each type of anchor?
  6. Are there any specific factors that may make one type of anchor more suitable for my individual case?
  7. How does the cost of using knotless anchors compare to knotted anchors?
  8. Are there any specific exercises or physical therapy recommendations that may be different depending on the type of anchor used?
  9. Have you had experience using both types of anchors in labral repair surgeries, and if so, do you have a preference based on your experience?
  10. Are there any ongoing studies or research that may impact the decision between knotless and knotted anchors for labral repair?

Reference

Authors: Matache BA, Hurley ET, Kanakamedala AC, Jazrawi LM, Virk M, Strauss EJ, Campbell KA. Journal: Arthroscopy. 2021 Apr;37(4):1314-1321. doi: 10.1016/j.arthro.2020.11.056. Epub 2020 Dec 9. PMID: 33307150