Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2013 Oct;54(10):555-9. doi: 10.11622/smedj.2013199.
This study aimed to evaluate the two-year clinical outcomes of arthroscopic Bankart repair augmented by plication of the inferior glenohumeral ligament (IGHL) via horizontal mattress suturing.
This study was a retrospective analysis of 76 arthroscopic Bankart repairs by a single surgeon from 2004 to 2008. Bioabsorbable suture anchors were used, with anchors placed at the 5:30, 4 and 3 o'clock positions of the right shoulder (correspondingly at the 6:30, 8 and 9 o'clock positions for the left shoulder). The lower most anchor was tied via horizontal mattress suture with plication of the IGHL, while the remaining two anchors were tied using simple sutures. The patients were postoperatively assessed, clinically and using the University of California Los Angeles (UCLA) shoulder rating scale.
The mean age of the patients at the time of presentation was 24.09 ± 7.98 years, and the mean duration of follow-up was 28.7 months. The postoperative recurrence rate of dislocation was 7.89% (six shoulders), of which five shoulders required revision surgeries. Excluding the revision cases, clinical assessment of the strength of the supraspinatus and the range of motion of the operated shoulders at two years post operation were either maintained or full in all patients. Analysis of the UCLA results showed pre- and postoperative mean scores of 25.94 ± 3.43 and 33.77 ± 3.07, respectively (p < 0.05).
Arthroscopic Bankart repair augmented by plication of the IGHL and anchored via horizontal mattress suturing is a safe and reliable treatment for shoulder instability, with good clinical outcomes and low recurrence rates.
本研究旨在评估通过水平褥式缝合对下盂肱韧带(IGHL)进行折叠来增强关节镜下 Bankart 修复的两年临床结果。
这是一项对 2004 年至 2008 年期间由同一位外科医生进行的 76 例关节镜下 Bankart 修复的回顾性分析。使用可吸收缝线锚钉,右肩的锚钉分别位于 5:30、4 和 3 点钟位置(相应的左肩为 6:30、8 和 9 点钟位置)。最下面的锚钉通过 IGHL 的水平褥式缝合打结,而其余两个锚钉通过简单的缝合打结。术后对患者进行临床和加利福尼亚大学洛杉矶分校(UCLA)肩部评分量表评估。
患者就诊时的平均年龄为 24.09 ± 7.98 岁,平均随访时间为 28.7 个月。脱位的术后复发率为 7.89%(六肩),其中五肩需要翻修手术。排除翻修病例,所有患者术后两年的冈上肌力量和手术肩活动范围的临床评估均保持或完全恢复。UCLA 结果分析显示,术前和术后的平均评分为 25.94 ± 3.43 和 33.77 ± 3.07,差异具有统计学意义(p<0.05)。
通过水平褥式缝合对 IGHL 进行折叠并通过锚钉固定的关节镜下 Bankart 修复是治疗肩关节不稳定的一种安全可靠的方法,具有良好的临床效果和低复发率。