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

Abstract

Objective: The aim of this study was to compare single and double anterior portal techniques in thearthroscopic treatment of traumatic anterior shoulder instability.Methods: A total of 91 cases who underwent arthroscopic Bankart repair for anterior shoulder instabilitywere 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; meanage: 25.4± 6.6) for the classical anterior double portal approach. The groups were compared for clinicalscores, range of motion, analgesia requirement, complications, duration of surgery, cost and learningcurve according to a short questionnaire completed by the relevant healthcare professionals.Results: No statistically signiŞcant difference was found between the 2 groups in terms of pre-operativeand post-operative Constant and Rowe Shoulder Scores, range of motion and complications (p> 0.05). InGroup 2 patients, the requirement for post-operative analgesics was signiŞcantly higher (p < 0.001),whereas the duration of surgery was statistically signiŞcantly shorter in Group 1 (p < 0.001). In theassessment of the questionnaire, it was seen that a single portal anterior approach was preferred at ahigher ratio (p¼ 0.035). The cost analysis revealed that the cost was 5.7% less for patients with a singleportal.Conclusion: In the arthroscopic treatment of traumatic anterior shoulder instability accompanied by aBankart lesion, the anterior single portal technique is as successful in terms of clinical results as theconventional double portal approach. The single portal technique has advantages such as less postoperative pain, a shorter surgical learning curve and lower costs.Level of Evidence: Level III, Therapeutic study.