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使用缝线锚钉技术进行关节镜下Bankart修复治疗创伤性前肩关节不稳

Arthroscopic Bankart repair in traumatic anterior shoulder instability using a suture anchor technique.

作者信息

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

机构信息

Department of Orthopaedics, University Hospital of Münster, Münster, Germany.

出版信息

Arthroscopy. 2006 Sep;22(9):931-6. doi: 10.1016/j.arthro.2006.04.105.

Abstract

PURPOSE

The purpose of this study was to prospectively evaluate the surgical outcome of arthroscopic Bankart repair via suture anchors in patients with recurrent traumatic anterior shoulder instability with a minimum follow-up of 2 years.

METHODS

We included 54 consecutive patients without an osseous Bankart lesion of greater than 25% of the glenoid circumference with a mean age of 25.3 years (range, 16 to 58 years) undergoing arthroscopic Bankart repair via suture anchors for traumatic anterior shoulder instability. The mean follow-up was 3.7 years (range, 2.3 to 5.2 years) at the final follow-up examination. Patients were evaluated prospectively according to the rating scales of Rowe, the American Shoulder and Elbow Surgeons, and Constant and Murley. One patient was lost to follow-up.

RESULTS

After 3.7 years, 4 patients had recurrent instability: 3 had redislocated and 1 had recurrent subluxations. Thus the overall redislocation rate was 7.5%. Of the 4 redislocators, 3 had a traumatic onset of the redislocation. All shoulder scores (Rowe, American Shoulder and Elbow Surgeons, and Constant and Murley) revealed highly significant improvements postoperatively. At final follow-up, 85.7% of patients had returned to their preoperative sports level.

CONCLUSIONS

Our results in this series demonstrate the efficacy of arthroscopic Bankart repair with suture anchors for the treatment of recurrent traumatic anterior shoulder instability with respect to recurrence rate, range of motion, and shoulder function during a mean follow-up of 3.7 years.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

本研究旨在前瞻性评估采用缝线锚钉进行关节镜下Bankart修复术治疗复发性创伤性前肩不稳患者的手术效果,随访时间至少为2年。

方法

我们纳入了54例连续患者,这些患者均无超过肩胛盂圆周25%的骨性Bankart损伤,平均年龄25.3岁(范围16至58岁),因创伤性前肩不稳接受关节镜下缝线锚钉Bankart修复术。末次随访时平均随访时间为3.7年(范围2.3至5.2年)。根据Rowe、美国肩肘外科医师协会以及Constant和Murley的评分量表对患者进行前瞻性评估。1例患者失访。

结果

3.7年后,4例患者出现复发性不稳:3例再次脱位,1例反复半脱位。因此总体再脱位率为7.5%。在这4例再脱位患者中,3例再脱位有创伤性起因。所有肩部评分(Rowe、美国肩肘外科医师协会以及Constant和Murley)术后均显示有高度显著改善。在末次随访时,85.7%的患者恢复到了术前的运动水平。

结论

我们这组病例的结果表明,在平均3.7年的随访期间,采用缝线锚钉进行关节镜下Bankart修复术治疗复发性创伤性前肩不稳,在复发率、活动范围和肩部功能方面均有疗效。

证据水平

IV级,治疗性病例系列。

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