Chen Shiyi, Haen Pieter Stijn, Walton Judie, Murrell George A C
Department of Orthopaedic Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Am J Sports Med. 2005 May;33(5):705-11. doi: 10.1177/0363546504270563. Epub 2005 Feb 16.
The effectiveness of arthroscopic thermal capsulorrhaphy in the prevention of recurrent instability in primary anterior stabilization is undetermined.
To determine if patients with recurrent anterior shoulder instability who have labral repair plus arthroscopic thermal capsulorrhaphy have better outcomes than those with labral repair alone.
Cohort study; Level of evidence, 3.
There were 72 patients who underwent arthroscopic anterior shoulder stabilization with Suretac II tacks (n = 32) during 1996 to 1999 or with Suretac II tacks plus arthroscopic radiofrequency capsular shrinkage (n = 40) from 1999 to 2002. Standardized patient-determined and examiner-determined outcome measures were obtained preoperatively and at 3, 6, 12, and 24 months postoperatively. Statistical analyses included a Kaplan-Meier analysis of time to recurrent instability.
Of the 72 patients, 66 had complete follow-up, including 28 patients treated with the Suretac stabilization and 38 patients with the Suretac plus radiofrequency shrinkage, for a mean follow-up of 58 and 30 months, respectively. All patients had a Bankart lesion. Both groups had similar results with respect to patient-determined and examiner-determined outcome measures. The only adverse outcome was postoperative recurrent instability in 6 of 28 cases in the Suretac group alone and 8 of 38 cases in the Suretac-plus -shrinkage group. Most recurrent instability occurred between 6 and 24 months. Kaplan-Meier analysis for time to recurrent instability showed no differences in the rate of instability recurrence between the 2 groups.
Arthroscopic thermal capsulorrhaphy neither enhanced nor impaired the outcomes of arthroscopic labral repair with biodegradable tacks in patients with primary recurrent anterior shoulder instability.
关节镜下热囊缩术在初次前向稳定手术中预防复发性不稳定的有效性尚未确定。
确定接受盂唇修复加关节镜下热囊缩术的复发性前肩不稳患者是否比单纯接受盂唇修复的患者有更好的疗效。
队列研究；证据等级，3级。
1996年至1999年期间，72例患者接受了使用Suretac II钉的关节镜下前肩稳定手术（n = 32），1999年至2002年期间，40例患者接受了使用Suretac II钉加关节镜下射频囊收缩术。术前以及术后3、6、12和24个月获得标准化的患者自评和检查者评定的疗效指标。统计分析包括复发性不稳定时间的Kaplan-Meier分析。
72例患者中，66例获得了完整随访，其中28例接受了Suretac稳定手术，38例接受了Suretac加射频收缩术，平均随访时间分别为58个月和30个月。所有患者均有Bankart损伤。两组在患者自评和检查者评定的疗效指标方面结果相似。唯一的不良结果是，仅Suretac组28例中有6例术后出现复发性不稳定，Suretac加收缩术组38例中有8例出现复发性不稳定。大多数复发性不稳定发生在6至24个月之间。复发性不稳定时间的Kaplan-Meier分析显示，两组之间不稳定复发率无差异。
对于原发性复发性前肩不稳患者，关节镜下热囊缩术既未增强也未损害使用可生物降解钉进行的关节镜下盂唇修复的疗效。
