Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Am J Sports Med. 2011 Nov;39(11):2396-403. doi: 10.1177/0363546511415657. Epub 2011 Jul 29.
Arthroscopic stabilization using suture anchors is widely used to restore stability after anterior shoulder dislocations and is associated with low recurrence rates in short-term follow-up studies.
To evaluate the long-term follow-up after arthroscopic stabilization for traumatic recurrent anterior instability using suture anchors with emphasis on both redislocations and subjective shoulder function.
Case series; Level of evidence, 4.
We included 67 consecutive patients with 70 affected shoulders. After 8 to 10 years, patients were asked to report the presence and course of their redislocations. Subjective shoulder function was addressed using the Oxford Instability Score (OIS), the Western Ontario Shoulder Instability Index (WOSI), and the Simple Shoulder Test (SST). Patients rated their health status using the Short Form-36 (SF-36).
Sixty-five patients with 68 affected shoulders (97%) were evaluated for follow-up; 35% reported a redislocation. Median shoulder function scores were 16 of 12 to 60, 22 of 0 to 210, and 12 of 0 to 12 for the OIS, WOSI, and SST, respectively. There was a significant difference in subjective function between patients with and without recurrent instability, respectively, 16 versus 24 for the OIS (P = .004), and 16 versus 47 for the WOSI (P = .05). We found a trend for an inverse relationship between the number of suture anchors and recurrent instability, with 2 having a higher recurrence rate than 3 or more (P = .06). Another trend was found with the presence of a Hill-Sachs defect slightly increasing the risk of a redislocation (P = .07).
With a follow-up of 97%, about one third of the stabilized shoulders experienced at least one redislocation after 8 to 10 years. The presence of a Hill-Sachs defect and the use of less than 3 suture anchors might increase the chance of a redislocation. Patients without a redislocation have a significantly better shoulder function compared with patients with a redislocation.
关节镜下使用缝线锚定物进行稳定术被广泛用于修复复发性前肩脱位后的稳定性，并且在短期随访研究中复发率较低。
评估关节镜下使用缝线锚定物进行创伤性复发性前不稳定的长期随访结果，重点关注再脱位和主观肩部功能。
病例系列；证据等级，4 级。
我们纳入了 67 例连续患者的 70 个患肩。在 8 至 10 年后，要求患者报告其再脱位的发生和过程。使用牛津不稳定评分（OIS）、Western Ontario 肩不稳定指数（WOSI）和简单肩部测试（SST）评估主观肩部功能。患者使用简明健康状况调查问卷（SF-36）评估其健康状况。
65 例患者的 68 个患肩（97%）接受了随访评估；35%的患者报告发生了再脱位。OIS、WOSI 和 SST 的中位数肩部功能评分为 16（12 至 60）、22（0 至 210）和 12（0 至 12）。有和无再不稳定的患者之间的主观功能存在显著差异，OIS 分别为 16 与 24（P =.004），WOSI 分别为 16 与 47（P =.05）。我们发现，缝线锚定物的数量与再不稳定之间存在反向关系的趋势，2 个锚定物的再脱位发生率高于 3 个或更多锚定物（P =.06）。另一个趋势是存在 Hill-Sachs 缺陷略微增加再脱位的风险（P =.07）。
随访 97%后，约有 1/3 的稳定肩在 8 至 10 年后至少经历了 1 次再脱位。Hill-Sachs 缺陷的存在和使用少于 3 个缝线锚定物可能会增加再脱位的机会。无再脱位的患者肩部功能明显优于有再脱位的患者。
