Paper #40 Arthroscopic repair of full thickness rotator cuff tears using bioabsorbable tacks

ABSTRACTS pain, which enables patients an early institution of their desired activities. Paper #39 Intraoperative And Late Complications In Arthroscopic Anterior Shoulder Instability Reconstruction. Kostas Karliaftis, Presenter, 401 General Army Hospital, Athens, Greece, Emmanuel Antonogiannakis, AthensCholargos, Greece, Christos K. Yiannakopoulos, Athens, Greece, Paul Labrinakos, Athens, Greece, Georgios Anastasios Babalis, N. Iraklio Attikis, Greece, Christos Karabalis, Athens, Greece, Panos Efstathiou, Athens, Greece We present our experience from the treatment of several complications which occurred during arthroscopic reconstruction of shoulder instability. Between September 1999 and May 2001 we treated 50 patients with anterior shoulder instability with arthroscopic Bankart repair. Of them 49 were males aged 19-33 years and 1 was female 24 years old. All operations were performed in the lateral decubitus position. Bankart lesion was reattached using suture anchors. Mean postoperative follow-up was 10-32 months. Intraoperatively sutures were broken in 7 cases, disengaged in 5 cases and instruments were broken in 3 cases. Transient hypoesthesia was noted in 3 cases. Postoperatively the instability recurred in two cases (1 subluxation, 1 dislocation), stiffness was noted in 3 cases, significant loss of external rotation was noted in 9 patients, pain during activities occurred in 10 cases and acromioclavicular pain was noted in 1 case. Arthroscopic reconstruction of shoulder instability is a safe method with few complications. Paper #40 Arthroscopic Repair Of Full Thickness Rotator Cuff Tears Using Bioabsorbable Tacks. Anthony Miniaci, MD, FRCSC, Presenter, Toronto Western Hospital, Toronto, Ontario, Canada, Julie McBirnie, FRCS, Scotland, Sara Miniaci, Canada Introduction: Techniques of rotator cuff repair continue to evolve. Although arthroscopic repair is becoming accepted, technical considerations of anchor placement and knot tying make this a difficult procedure. Tacks would simplify arthroscopic repairs but clinical reviews assessing their do not exist efficacy Purpose: This study was performed to evaluate the two year clinical results of arthroscopic rotator cuff repairs performed with bioabsorbable tacks (Suretac II). Materials and Methods: A retrospective review of prospectively collected data of 135 patients (86 males, 49 females) with mobile, full-thickness rotator cuff tears

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repaired arthroscopically by one surgeon using biodegradable tacks was performed. Average patient age was 52 years (range 23-74) and average time to review was 36 months (range 24-70 months). The patients were evaluated using the ASES and Constant Shoulder score, and the Short Form 36 health Survey (SF36). Results: Average size of tears measured 2.5 cm (range 1-5 cm) and on average 2 Suretacs (range 1-5) were used for the repair. Thirty-two patients had tears larger than 3 cm and 25 patients had tears that measured 5 cm or larger. The average total ASES score improved from 29 to 89 points with pain improving 7 to 1.2 and function from 7 to 25 points. All of these results were statistically significant (p ⬍ 0.01). There was a significant improvement in all components of the SF36 survey. The average postoperative Constant score was 89 with the pain measuring 12 points, ROM 39 and power 23 points. Discussion: These results show that arthroscopic repair of mobile, full-thickness rotator cuff tears using bioabsorbable tacks produces satisfactory outcomes with regard to objective orthopedic criteria. The advantages of arthroscopic repair are many but the procedure can be difficult. The use of tacks facilitates cuff repair without compromising the clinical result. Paper #41 Arthroscopic Subscapular Tenodesis In Shoulder Multidirectional Instability. Alberto Pienovi, Presenter, CTO, San Isidro, Argentina, Rafael Jose Tossi, Buenos Aires, Argentina, Luciano Quevedo, San Isidro, Argentina, Daniel Varela, San Isidro, Argentina Introduction: Shoulder instability is a frequent pathology among athletes. It may happen with true dislocation episodes, with subluxation or mainly with symptoms related to this pathology such as pain, subachromial impingement or lesions in the rotator cuff of different grades. Methods: In this prospective study, not randomized, we propose a rational classification that allows the identification of predisposing factors and the different lesion grades in order to select a determined arthroscopic treatment, increasing in complexity and repair. 186 cases were studied in this paper, which underwent an arthroscopy for shoulder instability. 56 cases were considered for this study as they were multidirectional instabilities and the multiple factors described in this paper were analyzed in these cases. Subscapular tenodesis was performed in 21 patients as an arthroscopic technique to stabilize the articulation. We have classified these factors in four groups in order to obtain a rational orientation of the arthroscopic treatment and to decide which one