Purpose. To evaluate the clinical outcome and risk factors for recurrent dislocation after arthroscopic stabilization with absorbable knotless anchor. Methods. We treated 197 patients affected by anterior shoulder instability, either traumatic or atraumatic with the same arthroscopic suture technique. We recorded age at surgery and number and type of dislocations (traumatic/atraumatic). Of the 197 patients, 127 (65.4%) were examined with a mean follow-up of 5.6 years (range: 25–108 months). Eighty-one shoulders were evaluated with the Rowe score and 48 with the Simple Shoulder Test (SST). Results. The mean Rowe score was 90.8, while the mean SST score was 10.9. Recurrence occurred in 10 cases (7.7%) but only in 4 cases was atraumatic, which reduces the real recurrence rate to 3.1%. Patients with recurrence were significantly younger at surgery than patients who did not relapse (). Moreover, neither the number () nor the type of shoulder instability (), or the amount of glenoid bone loss () significantly affected the probability of recurrence. Conclusions. In a patient population with involuntary monodirectional anterior shoulder instability, use of absorbable knotless anchor was reliable and resulted in a good outcome. In this series the statistical significant risk factors for recurrent dislocation were age of patient. 1. Introduction Unidirectional shoulder instability is a very frequent condition that generally responds well to arthroscopic surgery. However, arthroscopic procedures can fail due to such factors as patient age [1], number of previous dislocations and rehabilitation program [2], chondral and bone defects [3], sports activity [4], insufficient soft-tissue tensioning [5], failure of surgical devices [6], and bone quality [7]. Very little is known about risk factors associated with recurrence of shoulder instability after arthroscopic treatment. There appears to be no statistically significant differences in outcome using absorbable versus non absorbable sutures [8]. However, severe osteoarthritis has been associated with metal anchors [9]. Other complications have been reported in patients treated with bioknotless anchors. Athwal et al. [10] reported four failures that led to destructive glenoid osteolysis, anchor pull-out, and subsequent severe damage of the articular surface. Barber [11] described 2 failures: one due to rapid degradation of the suture anchor; the other because the upper part of the anchor and a portion of the eyelet became loose bodies as the anchor absorbed. Freehill et al. [12] reported synovitis, implant debris, and
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