Original Article
Absorbable Versus Nonabsorbable Sutures for the Arthroscopic Treatment of Anterior Shoulder Instability in Athletes: A Prospective Randomized Study

https://doi.org/10.1016/j.arthro.2007.12.013Get rights and content

Purpose: The purpose of this study was to compare the functional results of arthroscopic treatment for traumatic anterior shoulder instability in 2 groups of athletes. Methods: Fifty patients were randomly assigned to 2 different groups with comparable patient demographics. Group A was treated with anchors loaded with absorbable sutures, and group B was treated with the same type of anchors loaded with nonabsorbable sutures. The same type of absorbable anchor, surgical technique, and rehabilitation protocol was used in both groups. The outcomes were evaluated after a minimum postoperative period of 24 months. The Rowe score and the Athletic Shoulder Outcome Scoring System were applied, and statistical analysis was performed. Results: The mean Rowe score was 83.8 in group A and 79.5 in group B. The mean values for the Athletic Shoulder Outcome Scoring System were 84 and 79.2, respectively. Good or excellent results were found in 90.5% of patients in group A and 87.5% in group B. We had 2 failures (9.5%) in group A and 3 (12.5%) in group B. No statistically significant difference was found in the comparison of the outcomes (P > .05). Conclusions: The type of suture used, absorbable or nonabsorbable, did not influence the functional results of arthroscopic treatment for traumatic anterior shoulder instability in this series. Level of Evidence: Level II, therapeutic randomized controlled trial.

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Methods

All patients seen between August 2003 and March 2005 with traumatic anterior shoulder stability were considered for enrollment in our prospective randomized study. The patients were counseled regarding the nature of the operative procedure. The study was approved by the committee for ethics in research at our institution.

The inclusion criteria included a history and clinical findings of traumatic anterior shoulder instability and anteroinferior labral detachment on magnetic resonance imaging

Results

The 2 groups were comparable with respect to patient demographics, with no statistically significant difference when the variables were compared (Table 1, Table 2). The variables that could influence the results, such as age, number of episodes of dislocation before surgery, and sports activity level, were very homogeneous between the groups.

The mean Rowe score was 83.8 in group A and 79.5 in group B. The mean ASOSS scores were 84 and 79.2, respectively. Good or excellent results were found in

Discussion

The absorbable anchor used in our study is composed of polylactic acid (Panalok). According to the manufacturer, this anchor retains 90% of its original resistance at 9 months after implantation, enough time for healing of the soft tissues. Experiments with absorbable implants revealed that degradation began at 18 months after implantation, thus retaining the original resistance for a long period.1, 8

The use of bioabsorbable implants can be complicated by inflammatory responses. Despite the

Conclusions

Both groups had an acceptable rate of good and excellent results. Arthroscopic treatment was satisfactory in 90.5% of the athletes in group A and in 87.5% in group B, allowing them to return to sports activity. The results are comparable to those of other reports in the literature. There was no statistical difference between the groups. Our initial hypothesis was not confirmed by this study. The type of suture used, absorbable or nonabsorbable, did not influence the functional results of

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The authors report no conflict of interest.

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Copyright © 2008 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.