Arthroscopic Bankart Repair Using Knotless or BioKnotless Suture Anchors: 2- to 7-Year Results

Purpose: This study was performed to evaluate the results of arthroscopic Bankart repair, by use of Knotless or BioKnotless suture anchors (DePuy Mitek, Raynham, MA), for traumatic anterior shoulder instability. Methods: We performed a retrospective evaluation of 73 consecutive patients with traumatic anterior instability of the shoulder treated with arthroscopic Bankart repair by use of metallic Knotless or BioKnotless suture anchors. No additional capsular plication, thermal modification, or interval closure was performed in any patient. The senior author performed all procedures. Independent examiners performed physical examinations. Self-assessment questionnaire evaluations were completed, and preoperative and postoperative American Shoulder and Elbow Surgeons and Rowe scores are reported. Results: Results at a minimum of 2 years’ follow-up (range, 2 to 7 years) are reported for 72 patients (57 male and 15 female patients) available for follow-up evaluation. One patient was lost to follow-up. Of the patients, 5 (6.9%) had post-repair instability (3 dislocations and 2 subluxations). The mean postoperative loss of external rotation, at 90° of abduction, was 1°. All patients who had postoperative instability were aged 22 years or younger. The post-repair instability rate in this age group was 13.5% (5/37). No failures occurred in patients aged over 22 years. Of the post-repair dislocations, 3 (7.5%) were in patients involved in contact or collision sports. All 5 failures occurred early, within 2 years of the index surgery. Revision arthroscopic repairs via Knotless or BioKnotless suture anchors were performed in 3 of 4 patients, and a Latarjet procedure was also performed in the fourth patient. The fifth patient refused further intervention. All of the revision shoulders remained stable at the latest follow-up, 3 of which had at least 2 years of follow-up. Conclusions: Arthroscopic Bankart repair via Knotless or BioKnotless suture anchors showed a recurrence rate of 6.9%. Using Knotless or BioKnotless suture anchors provides satisfactory results with a low recurrence rate, minimal loss of motion, and reliable functional return, even in contact and collision athletes. Level of Evidence: Level IV, therapeutic case series.