| Abstract ID |
| 20260027 |
| Category |
| Shoulder: Instability |
| Preferable Presentation |
| Both |
| Title |
| CLINICAL OUTCOMES OF KNOTTED AND KNOTLESS ANCHOR TECHNIQUES IN ARTHROSCOPIC BANKART REPAIR: A RETROSPECTIVE ANALYSIS |
| Author |
|
| Presenter |
| Keith hay-man Wan |
| Abstract |
| Background: Arthroscopic Bankart repair is a widely performed procedure for recurrent anterior shoulder instability. Anchor design has evolved to optimize labral fixation and surgical outcomes. Knotted anchors provide reliable fixation but require knot tying, which may contribute to complications such as knot impingement or irritation. Knotless anchors, introduced more recently, offer potential advantages including simplified technique, reduced operative time, and improved biomechanical consistency. While biomechanical studies suggest superiority of knotless constructs, clinical evidence remains limited. Objectives: This study aimed to retrospectively compare the clinical outcomes of knotted versus knotless anchors in arthroscopic Bankart repair, focusing on functional recovery, recurrence of instability, and complication rates. Study Design: A retrospective, single‑centre review was conducted of patients undergoing arthroscopic Bankart repair between July 2022 and June 2025 at a district general hospital in Hong Kong. Patients with revision surgery or significant glenoid bone loss (>10%) were excluded. Eligible patients were stratified into two equal cohorts according to anchor type (knotted vs. knotless). The Constant‑Murley Score (CMS) was used as the primary outcome measure. Secondary outcomes included recurrence of instability and procedure‑related complications. All patients had a minimum of six months’ follow‑up. Results: Thirty‑six patients were included, with 18 allocated to each group and matched for age, sex, and activity level. Both groups demonstrated statistically significant improvement in Constant‑Murley Scores following surgery compared with their respective pre‑operative values. In the knotted anchor group, the mean score increased from 68.1 ± 19.9 pre‑operatively to 82.0 ± 10.1 post‑operatively (p < 0.05). In the knotless anchor group, the mean score rose from 70.0 ± 17.3 to 74.7 ± 16.9 (p < 0.05). At final follow‑up, the mean Constant‑Murley Score was 82.0 ± 10.1 in the knotted group and 74.7 ± 16.9 in the knotless group, with no statistically significant difference between cohorts (p > 0.05). No recurrence of shoulder instability was observed in either group during the follow‑up period. One case of superficial wound infection occurred in the knotted group, while no other complications were reported. Conclusion: Knotted and knotless anchor techniques yielded comparable short‑term outcomes in arthroscopic Bankart repair, with both approaches effectively restoring shoulder stability and improving functional scores. Although knotless anchors offer theoretical biomechanical advantages and technical simplicity, these benefits did not translate into superior clinical outcomes in this cohort. The findings highlight the importance of clinical validation of biomechanical innovations. Larger studies with extended follow‑up are warranted to better define long‑term efficacy, durability of repair, and potential differences in complication profiles between knotted and knotless constructs. |