Knotted versus Knotless Anchors for Labral Repair in the Sho
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The purpose of the current study is to compare biomechanical and clinical outcomes between knotless and knotted anchors in arthroscopic labral repair, specifically in 1) Bankart repair, 2) superior labrum, anterior-posterior (SLAP) repair, 3) posterior labral repair, and 4) remplissage augmentation of Bankart repair.

Results:
Overall, 17 studies met inclusion criteria. There were 7 studies evaluating the biomechanical outcomes, of which 5 found mixed results between knotted and knotless anchors for arthroscopic Bankart repair, 1 demonstrated a difference for SLAP repair favoring knotless anchors, and 2 showed no significant difference for Remplissage in terms of ultimate load-to-failure.

4 studies evaluated knotless labral anchors compared to knotted anchors in patients undergoing arthroscopic Bankart repair with no significant differences in outcomes reported between the two anchor types, except in one study that found an improved VAS score and a lower recurrence and revision rate with knotted anchors.

5 studies evaluated knotless anchors compared to knotted anchors in patients undergoing SLAP repair, and none of the included studies found any significant differences in the patient reported outcome measures or revision rates. Of the 5 studies comparing operative time, 4 found a reduced time with knotless anchors.

The clinical results show no significant differences in outcomes between knotless and knotted anchors for labral repair in the shoulder, including Bankart repair, SLAP repair, and posterior labral repair. However, there was conflicting evidence supporting knotless or knotted anchors in the biomechanical studies. However, operative times may be reduced with the use of knotless anchors.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0749806320310574
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