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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2002 March;53(1):1
Arthroscopic treatment of anterior glenohumeral instability. Literature review and recurrence rates metanalysis
Saccia F., Forti M., Massè A.
Background. Arthroscopic stabilization techniques for anterior glenohumeral instability show in the literature recurrence rates higher than the open Bankart repair; the purpose of this study is to analyse the results of the arthroscopic techniques reported in the literature.
Methods. Forty-seven follow-up studies about the three techniques usually performed for the arthroscopic stabilization have been analysed. The 13 studies comparing the results of the arthroscopic and the open treatment, eterogeneous for the arthroscopic technique performed, have been used for a recurrence rates metanalysis; furthermore, the results obtained by each arthroscopic technique have been individually analysed, and 2 more metanalyses have been performed for the bioabsorbable tacks and the suture anchors techniques.
Results. The trans-glenoid sutures technique shows a 22% recurrence rate; the bioabsorbable tacks technique a 12.9% recurrence rate; the anchors technique a 10.5% recurrence rate. The 3 arthroscopic techniques together show a 16.8% recurrence rate for arthroscopy, with a R.R. (Relative Risk of recurrence) of 2.91 compared with the open repair, and an O.R. (Odds Ratio) of 3.314. The bioabsorbable tacks technique has a R.R.=2.35 and an O.R.=2.561, the suture anchor one a RR=1.79 and an O.R.=1.899.
Conclusions. The recurrence rates of arthroscopic techniques prove to be higher than those of the open Bankart repair; however, for the arthroscopic anchors technique, a quick achievement of the 6% recurrence rate, ascribed by this and other studies to the open Bankart repair, is supposed.