Cooke Stephen J, Starks Ian, Kathuria Vinod
Department of Trauma & Orthopaedics, Stafford General Hospital, Stafford, UK.
Sports Med Arthrosc Rehabil Ther Technol. 2009 Jan 19;1(1):2. doi: 10.1186/1758-2555-1-2.
Shoulder instability is a common condition, particularly affecting a young, active population. Open capsulolabral repair is effective in the majority of cases, however arthroscopic techniques, particularly using suture anchors, are being used with increasing success.
15 patients with shoulder instability were operated on by a single surgeon (VK) using BioKnotless anchors (DePuy Mitek, Raynham, MA). The average length of follow-up was 21 months (17 to 31) with none lost to follow-up. Constant scores in both arms, patient satisfaction, activity levels and recurrence of instability was recorded.
80% of patients were satisfied with their surgery. 1 patient suffered a further dislocation and another had recurrent symptomatic instability. The average constant score returned to 84% of that measured in the opposite (unaffected) shoulder. There were no specific post-operative complications encountered.
In terms of recurrence of symptoms, our results show success rates comparable to other methods of shoulder stabilisation. This technique is safe and surgeons familiar with shoulder arthroscopy will not encounter a steep learning curve. Shoulder function at approximately 2 years post repair was good or excellent in the majority of patients and it was observed that patient satisfaction was correlated more with return to usual activities than recurrence of symptoms.
肩关节不稳是一种常见病症,尤其多见于年轻、活跃的人群。大多数情况下,开放性关节盂唇修复术是有效的,然而,关节镜技术,特别是使用缝合锚钉的技术,正越来越成功地被应用。
15例肩关节不稳患者由同一位外科医生(VK)使用BioKnotless锚钉(DePuy Mitek,美国马萨诸塞州雷纳姆)进行手术。平均随访时间为21个月(17至31个月),无失访病例。记录双臂的Constant评分、患者满意度、活动水平以及不稳复发情况。
80%的患者对手术满意。1例患者再次发生脱位,另1例有复发性症状性不稳。平均Constant评分恢复至对侧(未受影响)肩部测量值的84%。未遇到特定的术后并发症。
就症状复发而言,我们的结果显示成功率与其他肩关节稳定方法相当。该技术安全,熟悉肩关节镜检查的外科医生不会面临陡峭的学习曲线。修复后约2年时,大多数患者的肩部功能良好或极佳,并且观察到患者满意度与恢复日常活动的关联比与症状复发的关联更大。