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关节内紊乱性关节炎和钻孔样外观的关节镜下 Bankart 修复术后中-长期随访研究

Dislocation arthropathy and drill hole appearance in a mid- to long-term follow-up study after arthroscopic Bankart repair.

机构信息

Department of Orthopedics, Danderyd Hospital AB, 182 88, Stockholm, Sweden.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2156-62. doi: 10.1007/s00167-012-2076-5. Epub 2012 May 30.

Abstract

PURPOSE

The aim of this study was to perform a prospective mid- to long-term clinical and radiographic follow-up after arthroscopic Bankart repair using absorbable tacks with special emphasis on the development of dislocation arthropathy.

METHODS

Thirty-four shoulders in 32 patients with post-traumatic shoulder instability were included in the study. Clinical and radiographic follow-ups took place after approximately 2 and 8 years.

RESULTS

Thirty-four of 34 (100 %) shoulders in 32 patients returned for the follow-up examination after 95 (53-129) months. Pre-operatively, none of the shoulders had any arthropathy changes. At follow-up, 8/34 (24 %) had minor changes, 6/34 (18 %) had moderate changes, and none had severe arthropathy changes, a significant increment compared with the pre-operative figures (p = 0.005). At follow-up, the drill holes in 24 % of the shoulders still had not healed radiographically. The failure rate in terms of stability was 3/34 (9 %) re-dislocations and 3/34 (9 %) subluxations.

CONCLUSION

Eight years after arthroscopic Bankart repair using absorbable tacks, 41 % of the shoulders displayed some degree of radiographic arthropathy changes and in 24 % the drill holes had not yet radiographically healed. There was no correlation between clinical outcome or drill hole appearance and the development of arthropathy changes.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究旨在对使用可吸收钉行关节镜 Bankart 修复术后进行前瞻性的中至长期临床和影像学随访,特别关注脱位性关节炎的发展。

方法

研究纳入了 32 例创伤后肩关节不稳定患者的 34 肩。大约在 2 年和 8 年后进行临床和影像学随访。

结果

32 例患者中的 34 肩(100%)在 95 (53-129)个月后返回接受随访检查。术前,所有肩关节均无关节炎改变。随访时,8/34(24%)有轻微变化,6/34(18%)有中度变化,无严重关节炎变化,与术前相比显著增加(p=0.005)。随访时,24%的肩关节的钻孔仍未在影像学上愈合。在稳定性方面,失败率为 3/34(9%)再脱位和 3/34(9%)半脱位。

结论

在使用可吸收钉行关节镜 Bankart 修复术后 8 年,41%的肩关节出现了一定程度的影像学关节炎改变,24%的钻孔仍未在影像学上愈合。临床结果或钻孔外观与关节炎改变的发展之间无相关性。

证据等级

III。

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