Evidence map›Paper›PMID 40483425›Full record

SynthesisBMC musculoskeletal disorders2025

Knotless versus knotted arthroscopic Bankart repairs for anterior shoulder instability: a systematic review and meta-analysis.

Cheng Wang, Yanhang Liu, Meng Ding, Sha Wan, Kefu Lin, Zhen Tian, Lang Li

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Cheng Wang *Department of Orthopedics, Chengdu Jinniu District Traditional Chinese Medicine Hospital, Chengdu, 610041, People's Republic of China.
Yanhang LiuDepartment of Orthopedics, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, People's Republic of China.
Meng DingDepartment of Rehabilitation, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, People's Republic of China.
Sha WanDepartment of Orthopedics, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, People's Republic of China.
Kefu LinDepartment of Orthopedics, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, People's Republic of China.
Zhen TianDepartment of Orthopedics, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, People's Republic of China.
Lang Li *Department of Orthopedics, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, People's Republic of China. lilang84@126.com.

Funding

Chengdu Medical Research Project 2024158Tibet Autonomous Region Science and Technology Plan Joint Funding Project XZ202403ZY0025
6 · The paper itself

Abstract

backgroundArthroscopic Bankart repair can be performed via a more contemporary knotless procedure or a more traditional knotted procedure. Nonetheless, comparisons between these two techniques remain controversial.

methodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science was conducted. Randomized controlled trials (RCTs) and cohort studies directly comparing the knotless and knotted arthroscopic Bankart procedures were included. The primary outcomes were rates of recurrent instability and revision surgeries. Secondary outcomes encompassed number of anchors, operative time, improvements in functional scores including Rowe score and Constant-Murley score (CMS), pain level assessed by the visual analogue scale (VAS) score, range of motion (ROM), adverse events, and radiological results. Quality assessment was performed using RoB2 and MINORS tools. Meta-analysis pooled RCT data using Review Manager 5.4.1, and non-pooled outcomes from cohort studies or limited RCT data were reported separately.

resultsThis meta-analysis included nine studies with a total of 729 patients. Pooled data from three RCTs demonstrated no significant differences between the two techniques in terms of re-dislocation (P = 0.78), recurrent anterior subluxation and positive apprehension test (P = 0.78), revision surgery (P = 0.94), number of anchors used (P = 0.26), or improvements in Rowe score (P = 0.15). For outcomes not suitable for pooling, qualitative analysis of trends indicated comparable outcomes between the groups, except a slightly reduced operative time in the knotless repair group. Adverse events were infrequently reported and occurred at similar rates in both groups. Limited radiological data from one RCT showed no significant differences in MRI parameters at the 24-month follow-up.

conclusionBoth techniques demonstrate comparable clinical outcomes. The only potential advantage of the knotless technique is a possible reduction in operative time, though its clinical significance remains uncertain. Given the limitations of the evidence, these findings should be interpreted cautiously. CLINICAL TRIAL NUMBER: Not applicable. PROSPERO REGISTRATION ID: CRD42024586135.

Indexed as

ArthroscopyJoint InstabilityShoulder DislocationShoulder JointSuture TechniquesHumansRandomized Controlled Trials as TopicRange of Motion, ArticularReoperationTreatment OutcomeAnterior shoulder instabilityBankart repairKnotlessKnottedMeta-analysis

Identifiers

PMID40483425
PMCPMC12144794

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.