Department of Orthopaedics and Traumatology, Catholic University, Largo A Gemelli, 8, 00168 Rome, RM, Italy.
Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1785-91. doi: 10.1007/s00167-010-1212-3. Epub 2010 Jul 17.
The purpose of this study was to compare the clinical outcome of arthroscopic treatment of shoulder instability with metal and biodegradable suture anchors.
Arthroscopic stabilization was performed in 78 patients with recurrent traumatic anterior shoulder instability. They were divided into 2 groups of 39 patients each, according to suture anchors used: metal anchors in group 1, and biodegradable anchors in group 2. Results were evaluated by use of the Disabilities of the Arm, Shoulder and Hand (DASH) self-administered questionnaire; Rowe score; Constant score normalized for age and gender, and recurrence of dislocation.
On analyzing the results at a 2-year follow-up, we considered the following independent variables: age; gender; arm dominance; duration of symptoms, age at first dislocation, number of dislocations, type of work; type of sport; sports activity level; lesion of the anterior labrum and anterior-inferior gleno-humeral ligament; SLAP lesion, and number of suture anchors. Comparison between groups did not show significant differences for each variable considered. Overall, according to the results, median DASH scores were 4.5 points (range 0-27) in group 1 and 7 points (range 0-25) in group 2 (n.s.); median Rowe scores were 100 points (range 60-100) and 100 points (range 25-100), respectively (n.s.); and median Constant scores were 98 points (range 81-107) and 98 points (range 87-121), respectively (n.s.). Recurrence was observed in 1 patient (2.8%) in group 1 and in 2 patients (5.9%) in group 2. Overall recurrence rate was 4.3%. Univariate and multivariate analysis showed that age, duration of symptoms, number of dislocations, type of work, and type of sports significantly and independently influenced the outcomes. Differences between groups 1 and 2 were not significant.
At a short-term follow-up, differences between arthroscopic shoulder stabilization with metal and biodegradable suture anchors were not statistically significant. Clinical relevance of the study is that there is no difference in the use of metal or biodegradable suture anchors for the arthroscopic treatment of shoulder instability.
本研究旨在比较关节镜下治疗肩不稳采用金属和可生物降解缝线锚钉的临床疗效。
对 78 例复发性创伤性前肩不稳患者进行关节镜下稳定治疗。根据缝线锚钉的使用情况，将患者分为两组，每组 39 例：组 1 使用金属锚钉，组 2 使用可生物降解锚钉。采用手臂残疾、肩和手（DASH）自我管理问卷、Rowe 评分、年龄和性别标准化的 Constant 评分以及脱位复发情况评估结果。
在 2 年随访时分析结果，我们考虑了以下独立变量：年龄、性别、手臂优势、症状持续时间、初次脱位年龄、脱位次数、工作类型、运动类型、运动活动水平、前盂唇和前下盂肱韧带损伤、SLAP 损伤以及缝线锚钉数量。对每个考虑的变量进行组间比较，差异均无统计学意义。总体而言，根据结果，组 1 的 DASH 评分中位数为 4.5 分（范围 0-27），组 2 为 7 分（范围 0-25）（无统计学差异）；Rowe 评分中位数分别为 100 分（范围 60-100）和 100 分（范围 25-100）（无统计学差异）；Constant 评分中位数分别为 98 分（范围 81-107）和 98 分（范围 87-121）（无统计学差异）。组 1 中有 1 例（2.8%）患者复发，组 2 中有 2 例（5.9%）患者复发。总体复发率为 4.3%。单因素和多因素分析显示，年龄、症状持续时间、脱位次数、工作类型和运动类型显著且独立地影响了结果。组 1 和组 2 之间的差异无统计学意义。
在短期随访中，关节镜下采用金属和可生物降解缝线锚钉治疗肩不稳的差异无统计学意义。本研究的临床意义在于，关节镜下治疗肩不稳时，使用金属或可生物降解缝线锚钉无差异。
