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Do Knots Matter in Superior Labrum Anterior to Posterior Lesions Repair?
Clinics in Shoulder and Elbow 2017;20:68-76
Published online June 30, 2017
© 2017 Korean Shoulder and Elbow Society.

Hyeon Jang Jeong, Ho Yun Joung1, Dae Ha Kim, Sung Min Rhee, Seok Hoon Yang, Woo Kim2, Joo Han Oh

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, 1Department of Orthopedic Surgery, Wonkwang University Sanbon Hospital, Gunpo, 2Department of Orthopedic Surgery, Nalgae Hospital, Seoul, Korea
Correspondence to: Joo Han Oh
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173beon-gil, Bundang-gu, Seongnam 13620, Korea
Tel: +82-31-787-7197, Fax: +82-31-787-4056, E-mail: ohjh1@snu.ac.kr
Received September 1, 2016; Revised February 3, 2017; Accepted February 26, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a 쐊not-ache. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications.
Methods: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed.
Results: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3.
Conclusions: The knots of suture anchor maybe a possible etiology of the pain, which we termed a 쐊not-ache. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, 쐊not-ache. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.
Keywords : Arthroscopy; Postoperative complications; Reoperation; Suture anchors