Knotless and knotted all-suture anchors have comparable clinical outcomes and return to sport rates following arthroscopic anterior labral (Bankart) repair.

Townsend, Clay B; Vega, Tomas F; Ithurburn, Matthew P; Loeb, Alexander E; Atkinson, Andrew; Froom, Ryan; Crawford, Anna E; Kidwell-Chandler, Ariel L et al. · Shoulder Elbow · 2026

retrospective_cohort · Level III

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Abstract

This retrospective comparative study aimed to characterize the clinical outcomes of patients undergoing arthroscopic labral repair using either knotless or knotted all-suture anchors. This study identified all patients who underwent arthroscopic Bankart repair with all-suture anchors, both knotless and knotted, with at least 2 years of follow-up. Demographic, athletic, return-to-sport, surgical, and functional outcomes data, including American Shoulder and Elbow Surgery (ASES) and Western Ontario Shoulder Instability Index (WOSI) scores, were collected and compared between anchor groups. Outcomes data were collected for 192 patients, with an average follow-up of 3.1 years and a mean age of 23.8 years. Among anchor types, 72% were knotless-only (138/192), 13% knotted-only (26/192), and 14% combined (28/192). There were no differences in rates of revision shoulder surgery, rates of return to sport, or postoperative ASES or WOSI scores when comparing anchor types (<i>p</i> > .05). Among competitive athletes (66% of cohort) who attempted to return to preinjury level of sport, 95% (88/93) were able to. Knotless and knotted all-suture anchors demonstrated comparable revision rates, patient-reported outcomes, and return to preinjury sport rates for patients who underwent arthroscopic Bankart repair.