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使用生物可吸收钉进行关节镜下Bankart修复的长期结果。

Long-term results of arthroscopic Bankart repair with a bioabsorbable tack.

作者信息

Marquardt Björn, Witt Kai-Axel, Götze Christian, Liem Dennis, Steinbeck Jörn, Pötzl Wolfgang

机构信息

Department of Orthopaedics, University Hospital of Münster, Albert-Schweitzer Str 33, 48129 Münster, Germany.

出版信息

Am J Sports Med. 2006 Dec;34(12):1906-10. doi: 10.1177/0363546506290404. Epub 2006 Aug 10.

Abstract

BACKGROUND

Short-term to midterm data are available on arthroscopic shoulder stabilization using bioabsorbable tacks or suture anchors. It remains unknown whether these techniques can equal the success of open Bankart repair in the long term.

PURPOSE

To assess the long-term outcome of arthroscopic Bankart repair using bioabsorbable tacks in patients with traumatic anterior shoulder instability with a minimum follow-up of 7 years.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Treatment outcomes were determined prospectively according to the Rowe score and retrospectively according to the Constant and American Shoulder and Elbow Surgeons scores. Included in this study were 18 consecutive patients with a mean age of 26.8 years (range, 16-62 years) who underwent arthroscopic Bankart repair using bioabsorbable tacks for traumatic anterior shoulder instability. The study group consisted of 14 male and 4 female patients. The mean follow-up was 8.7 years (range, 7.0-9.8 years).

RESULTS

One patient had recurrent dislocations requiring further surgery, for an overall failure rate of 5.6%. An additional patient had 1 traumatic subluxation episode within the first postoperative year that did not recur. According to the Rowe score, which increased to 90.3 (17.8) from 32.8 (8.3) points preoperatively, 15 patients (83.3%) achieved a good or excellent result. The mean Constant score was 91.3 (SD, 6.9) points, and the mean American Shoulder and Elbow Surgeons score was 92.1 (SD, 6.9) points postoperatively. A return to the preinjury level of sports competition was reported by 64% of patients. No signs of synovitis occurred in any patient postoperatively.

CONCLUSION

Arthroscopic Bankart repair for the treatment of recurrent traumatic anterior shoulder instability repair using bioabsorbable tacks offers reliable results with respect to failure rate, range of motion, and shoulder function during a minimum follow-up of 7.0 years. In contrast to previous reports on arthroscopic Bankart repair, results did not deteriorate during follow-up.

摘要

背景

关于使用生物可吸收钉或缝线锚钉进行关节镜下肩关节稳定术的短期至中期数据已有报道。但从长期来看,这些技术是否能与开放性Bankart修复术的成功率相当仍不清楚。

目的

评估在创伤性前肩关节不稳患者中使用生物可吸收钉进行关节镜下Bankart修复术的长期疗效,最小随访时间为7年。

研究设计

病例系列;证据等级,4级。

方法

前瞻性地根据Rowe评分确定治疗结果,回顾性地根据Constant评分和美国肩肘外科医师学会(ASES)评分确定治疗结果。本研究纳入了18例连续患者,平均年龄26.8岁(范围16 - 62岁),他们因创伤性前肩关节不稳接受了使用生物可吸收钉的关节镜下Bankart修复术。研究组包括14例男性和4例女性患者。平均随访时间为8.7年(范围7.0 - 9.8年)。

结果

1例患者出现复发性脱位需要进一步手术,总体失败率为5.6%。另1例患者在术后第1年内发生1次创伤性半脱位,未再复发。根据Rowe评分,术前为32.8(8.3)分,术后增至90.3(17.8)分,15例患者(83.3%)获得良好或优秀结果。术后Constant评分平均为91.3(标准差,6.9)分,ASES评分平均为92.1(标准差,6.9)分。64%的患者报告恢复到受伤前的运动竞赛水平。术后所有患者均未出现滑膜炎迹象。

结论

对于复发性创伤性前肩关节不稳,使用生物可吸收钉进行关节镜下Bankart修复术在至少7.0年的随访期间,在失败率、活动范围和肩关节功能方面提供了可靠的结果。与先前关于关节镜下Bankart修复术的报道不同,随访期间结果并未恶化。

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