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关节镜下失败的关节镜下Bankart修复术的挽救治疗:一项至少随访4年的前瞻性研究。

Arthroscopic salvage of failed arthroscopic Bankart repair: a prospective study with a minimum follow-up of 4 years.

作者信息

Franceschi Francesco, Longo Umile Giuseppe, Ruzzini Laura, Rizzello Giacomo, Maffulli Nicola, Denaro Vincenzo

机构信息

Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy.

出版信息

Am J Sports Med. 2008 Jul;36(7):1330-6. doi: 10.1177/0363546508314403. Epub 2008 Mar 28.

Abstract

BACKGROUND

Data on arthroscopic salvage of failed arthroscopic Bankart repair are lacking.

PURPOSE

To prospectively evaluate the surgical outcome of arthroscopic salvage of failed arthroscopic Bankart repair.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Operations were performed on 10 patients (8 male and 2 female; mean age at revision, 25.6 years; range, 18-41 years). The mean interval from the time of the revision surgery to the final follow-up was 68 months (range, 46-83 months). Objective testing included preoperative and postoperative range of motion. Outcome measures included the rating system of the University of California at Los Angeles. The surgical procedure was performed in a consistent manner: capsular plications, suture anchor repair of the displaced labrum, and, when indicated, rotator interval closure.

RESULTS

The University of California at Los Angeles rating system showed a statistically significant improvement from a preoperative mean rating of 11.7 (range, 6-14) to a mean of 31.7 (range, 29-35) postoperatively (P < .05). All patients had a full and equal postoperative range of motion compared with the preoperative range of motion. One patient experienced recurrent dislocations after the salvage procedure. None of the other 9 patients experienced a recurrent dislocation, with all returning to their previous sports levels.

CONCLUSION

Arthroscopic Bankart revision surgery is a reliable procedure with respect to recurrence rate, range of motion, and shoulder function in carefully selected patients.

摘要

背景

关于关节镜下挽救失败的关节镜下Bankart修复术的数据尚缺乏。

目的

前瞻性评估关节镜下挽救失败的关节镜下Bankart修复术的手术效果。

研究设计

病例系列;证据等级,4级。

方法

对10例患者(8例男性,2例女性;翻修时平均年龄25.6岁;范围18 - 41岁)进行手术。从翻修手术至最终随访的平均间隔时间为68个月(范围46 - 83个月)。客观测试包括术前和术后的活动范围。结果指标包括加利福尼亚大学洛杉矶分校评分系统。手术操作方式一致:关节囊折叠、移位盂唇的缝线锚钉修复,必要时行旋转间隙闭合。

结果

加利福尼亚大学洛杉矶分校评分系统显示,术前平均评分为11.7(范围6 - 14),术后平均评分为31.7(范围29 - 35),差异有统计学意义(P < .05)。与术前活动范围相比,所有患者术后均有完全且相等的活动范围。1例患者在挽救手术后出现复发性脱位。其他9例患者均未出现复发性脱位,全部恢复到之前的运动水平。

结论

对于精心挑选的患者,关节镜下Bankart翻修手术在复发率、活动范围和肩部功能方面是一种可靠的手术。

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