Wintzell G, Haglund-Akerlind Y, Ekelund A, Sandström B, Hovelius L, Larsson S
Department of Orthopaedics, Uppsala University Hospital, Sweden.
Knee Surg Sports Traumatol Arthrosc. 1999;7(3):192-6. doi: 10.1007/s001670050146.
Young individuals have a high recurrence rate following non-operative treatment of traumatic primary anterior shoulder dislocation. The present multicentre study was undertaken to find out whether the results could be improved by using arthroscopic lavage as treatment. Sixty patients aged 16-30 years, with traumatic primary anterior shoulder dislocation were randomised into two groups. One group was treated with arthroscopic lavage within 10 days, while the other group was treated non-operatively. Rehabilitation was otherwise identical. At 1-year follow-up, 4 of 30 patients (13%) in the lavage group had had redislocation compared with 13 of 30 (43%) in the group treated non-operatively (P = 0.01). The difference in recurrence rate was more pronounced in younger patients. The functional outcome according to the Rowe shoulder score was better in the lavage group (P = 0.003), as was the anterior stability according to the apprehension test (P = 0.008). We conclude that arthroscopic lavage reduced the recurrence rate and produced a better functional outcome at 1-year follow-up than the non-operative treatment in young individuals.
年轻个体创伤性原发性肩关节前脱位非手术治疗后的复发率较高。本多中心研究旨在探讨采用关节镜灌洗治疗是否能改善治疗效果。60例年龄在16至30岁之间的创伤性原发性肩关节前脱位患者被随机分为两组。一组在10天内接受关节镜灌洗治疗,另一组接受非手术治疗。两组的康复方案相同。在1年随访时,灌洗组30例患者中有4例(13%)再次脱位,而非手术治疗组30例中有13例(43%)再次脱位(P = 0.01)。复发率的差异在年轻患者中更为明显。根据Rowe肩关节评分,灌洗组的功能结果更好(P = 0.003),根据恐惧试验,前稳定性也是如此(P = 0.008)。我们得出结论,在1年随访时,与年轻个体的非手术治疗相比,关节镜灌洗降低了复发率并产生了更好的功能结果。