ArticleOrthopaedic journal of sports medicine2025
Similar Redislocation Rates Between Knot-Tying and Knotless Suture Anchor for Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Traumatic anterior shoulder dislocations in young adults often result in Bankart lesions, which contribute to recurrent instability. Arthroscopic Bankart repair is a commonly utilized and well-established treatment option that employs either knot-tying or knotless suture anchors. While knot-tying suture anchors allow for customizable tensioning and have demonstrated strong fixation, they require technical expertise and may be associated with complications related to knots. Knotless anchors offer a simplified technique and eliminate knot-related issues, although they may provide less intraoperative adjustability. Purpose: To compare the clinical outcomes of knot-tying and knotless suture anchors in arthroscopic Bankart repair for anterior shoulder instability. Study Design: Systematic review and meta-analysis; Level of evidence, 3. Methods: PubMed, Scopus, and Ovid Medline databases were searched up to January 2025. The inclusion criteria encompassed comparative studies (levels 1-3) reporting redislocation rates, revision rates, patient-reported outcomes, or range of motion. Data were independently extracted and quality assessed using the Methodological Index for Non-Randomized Studies and the Modified Coleman Methodology Score criteria. Statistical analyses utilized fixed- or random-effects models based on heterogeneity. Results: Ten studies comprising 793 patients-415 in the knot-tying group and 378 in the knotless group (mean age, 21.1-32.6 years)-met the inclusion criteria. Redislocation rates were 9.5% and 10.6% for knot-tying and knotless anchors, respectively, with no significant difference (odds ratio [OR], 0.95; Conclusion: Knot-tying and knotless suture anchors yield similar outcomes for arthroscopic Bankart repair regarding redislocation, revision rates, and functional recovery. Knot-tying anchors may slightly reduce pain; however, the magnitude of this difference appears to be below the threshold for clinical importance. Both techniques are viable, allowing surgeons to base their choice on preference and case specifics.
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