Single anterior portal: A better option for arthroscopic treatment of traumatic anterior shoulder instability?

Abstract

ObjectiveThe aim of this study was to compare single and double anterior portal techniques in the arthroscopic treatment of traumatic anterior shoulder instability.MethodsA total of 91 cases who underwent arthroscopic Bankart repair for anterior shoulder instability were reviewed. The patients were divided into 2 groups as Group 1 (47 male and 2 female; mean age: 25.8 ± 6.8) for arthroscopic single anterior portal approach and Group 2 (41 male and 1 female; mean age: 25.4 ± 6.6) for the classical anterior double portal approach. The groups were compared for clinical scores, range of motion, analgesia requirement, complications, duration of surgery, cost and learning curve according to a short questionnaire completed by the relevant healthcare professionals.ResultsNo statistically significant difference was found between the 2 groups in terms of pre-operative and post-operative Constant and Rowe Shoulder Scores, range of motion and complications (p > 0.05). In Group 2 patients, the requirement for post-operative analgesics was significantly higher (p < 0.001), whereas the duration of surgery was statistically significantly shorter in Group 1 (p < 0.001). In the assessment of the questionnaire, it was seen that a single portal anterior approach was preferred at a higher ratio (p = 0.035). The cost analysis revealed that the cost was 5.7% less for patients with a single portal.ConclusionIn the arthroscopic treatment of traumatic anterior shoulder instability accompanied by a Bankart lesion, the anterior single portal technique is as successful in terms of clinical results as the conventional double portal approach. The single portal technique has advantages such as less postoperative pain, a shorter surgical learning curve and lower costs.Level of EvidenceLevel III, Therapeutic study.

Anterior Shoulder Stabilization Using a Single Portal Technique With Suture Lasso

“…Some authors have recommended that after each stitch is placed, its anchor should be placed to avoid excessive sutures entangling and obstructing the anterior portal. 8 However, we have found no difficulty in placing 2 sutures before placing an anchor. In cases where the capsule is capacious and a healthy bite cannot be achieved initially, we pass one suture that serves as a tensioning suture while placing a second suture with a healthier bite of capsular tissue.…”

Comparison of anterior single- and standard two-portal techniques in arthroscopic Bankart repair

“…[2][3][4][5]18,19] The advantages of ABR are as follows: less postoperative pain, less loss of motion, shorter length of hospital stay, lower morbidity rates, shorter operative time, and better cosmetic appearance. [20] Previously, the standard anterior two-portal technique was used in ABR surgery; however, the single anterior portal technique, which is less invasive, has been introduced and increasingly used over the past five years. [2,5,11,18-20-22] This present study evaluated the effectiveness of single anterior portal technique as an up-to-date treatment method in ABR.…”

Comment on: “Single anterior portal: A better option for arthroscopic treatment of traumatic anterior shoulder instability?”

“…I read with interest the article entitled “Single anterior portal: A better option for arthroscopic treatment of traumatic anterior shoulder instability?” by Çiçek et al. published online 1 . I congratulate the authors for the interesting study and the results obtained.…”

“…published online. 1 I congratulate the authors for the interesting study and the results obtained. The authors concluded that single anterior portal technique for patients undergoing surgery for arthroscopic repair of Bankart lesion is more cost-effective and requires less postoperative analgesia compared to patients operated with two anterior portals.…”