The “purse string” technique for anterior glenohumeral instability: long-term results 7–13-year follow-up

Georgios Panagopoulos*, Girolamo Picca, Aleksandra Adamczyk, Andreas Leonidou, Paolo Consigliere, Giuseppe Sforza, Ehud Atoun, Ehud Rath, Ofer Levy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: The “Purse-String Technique” (PST) is an arthroscopic horizontal mattress suture technique for recurrent anterior shoulder instability that uses a single double-loaded suture anchor at the 4-o’ clock position, achieving a Bankart labral repair and an infero-superior capsular shift. In this study, we describe the long-term results of the PST. Methods: The study included 69 individuals (70 shoulders), with a mean age of 30 years, who had recurrent post-traumatic anteroinferior instability. A purse-string suture anchor at the 4-o'clock position was used to address the Bankart lesion and capsular laxity, recreating the anterior glenoid bumper. All patients were assessed via telephone interview at a mean of 116 months after surgery (7–13-year follow-up). Results: Postoperatively, the mean Constant score was 94, mean Rowe score was 93 and mean Walch–Duplay score was 89. 89% of patients resumed their preinjury sport activities, with 61% of patients achieving preinjury levels and most professional athletes returning to full activity. Seven patients had recurrent dislocation postoperatively (10% failure rate). Of these patients, three had revision arthroscopic stabilization, one patient had revision arthroscopic stabilization with remplissage, two had a Latarjet procedure, whereas one patient decided to seek no further treatment. Conclusion: The long-term results of PST are promising, with a low failure rate, high patient satisfaction and a high rate of return to sport. Level of evidence: Level IV; Case series; Treatment study.

Original languageEnglish
Pages (from-to)2317-2323
Number of pages7
JournalEuropean Journal of Orthopaedic Surgery and Traumatology
Issue number6
StatePublished - Aug 2023


  • Arthroscopic
  • Bankart repair
  • Instability
  • Long-term follow-up
  • Shoulder


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