Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada.
Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1742-7. doi: 10.1007/s00167-010-1093-5. Epub 2010 Mar 17.
Purpose of this study is to conduct a meta-analysis comparing the results of open and arthroscopic Bankart repair using suture anchors in recurrent traumatic anterior shoulder instability. Using Medline Pubmed, Cochrane and Embase databases we performed a search of all published articles. We included only studies that compared open and arthroscopic repair using suture anchors. Statistical analysis was performed using chi-square test. Six studies met the inclusion criteria. The total number of patients was 501, 234 suture anchors and 267 open. The rate of recurrent instability in the arthroscopic group was 6% versus 6.7% in the open group; rate of reoperation was 4.7% in the arthroscopic group vs. 6.6% in open (difference not statistically significant). The difference was statistically significant only in the studies after 2002 (2.9% of recurrence in the arthroscopic group vs. 9.2% in open; 2.2% of reoperation in the arthroscopic group vs. 9.2% in open). Results regarding function couldn't be combined because of non-homogeneous scores reported in the original articles, but the arthroscopic treatment led to better functional results. Arthroscopic repair using suture anchors results in similar redislocation and reoperation rate compared to open Bankart repair; however, we need larger and more homogeneous prospective studies to confirm these findings.
本研究旨在通过对比使用缝合锚进行开放式和关节镜下 Bankart 修复治疗复发性创伤性前肩不稳定的结果,进行一项荟萃分析。我们通过 Medline Pubmed、Cochrane 和 Embase 数据库,对所有已发表的文章进行了检索。我们仅纳入了比较使用缝合锚进行开放式和关节镜下修复的研究。使用卡方检验进行统计学分析。符合纳入标准的研究有 6 项。总共有 501 例患者,其中 234 例使用缝合锚进行关节镜下修复,267 例进行开放式修复。关节镜组的复发性不稳定率为 6%,而开放式组为 6.7%;关节镜组的再次手术率为 4.7%,而开放式组为 6.6%(差异无统计学意义)。仅在 2002 年后的研究中差异具有统计学意义(关节镜组的复发率为 2.9%,而开放式组为 9.2%;关节镜组的再次手术率为 2.2%,而开放式组为 9.2%)。由于原始文章中报告的评分不一致,因此无法对功能结果进行合并,但关节镜治疗可带来更好的功能结果。与开放式 Bankart 修复相比,使用缝合锚进行关节镜下修复的结果具有相似的再脱位和再次手术率;然而,我们需要更大且更同质的前瞻性研究来证实这些发现。