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肩关节脱位后关节镜下同时进行肩袖修复和Bankart修复的功能及影像学结果。

Functional and imaging outcomes of arthroscopic simultaneous rotator cuff repair and bankart repair after shoulder dislocations.

作者信息

Shields Edward, Mirabelli Mark, Amsdell Simon, Thorsness Robert, Goldblatt John, Maloney Michael, Voloshin Ilya

机构信息

Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.

Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA

出版信息

Am J Sports Med. 2014 Nov;42(11):2614-20. doi: 10.1177/0363546514550993. Epub 2014 Sep 26.

Abstract

BACKGROUND

Previous studies have investigated outcomes of simultaneous rotator cuff (RC) repair and superior labral injury repair; however, there is limited information in the literature on outcomes of simultaneous RC repair and Bankart lesion repair after acute shoulder dislocations.

PURPOSE

To determine functional and imaging outcomes of simultaneous arthroscopic RC repair and Bankart repair after acute shoulder dislocations and to compare functional outcomes to contralateral, asymptomatic shoulders.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Consecutive patients who underwent arthroscopic simultaneous RC repair and Bankart repair with a minimum of 2 years' follow-up were recruited. All patients had suffered an acute shoulder dislocation. The American Shoulder and Elbow Surgeons (ASES), Constant-Murley, and Short Form (SF)-36 scores were obtained. The affected shoulder also underwent ultrasound imaging to assess the integrity of the RC.

RESULTS

Thirteen patients (mean age, 58.8 ± 11.2 years; mean follow-up, 38.5 ± 12.3 months) were recruited. In a comparison of the affected versus unaffected shoulder, there were no significant differences in the mean ASES score (89.7 ± 12.6 vs 95.0 ± 6.7, respectively), mean Constant score (80.5 ± 18.9 vs 86.8 ± 7.9, respectively), or mean abduction strength (15.4 ± 6.4 lb vs 15.4 ± 5.2 lb, respectively) (P > .05). The mean SF-36 physical component summary was 48.4. According to ultrasound imaging, there were persistent/recurrent full-thickness tears in 4 patients, and 1 patient had a new full-thickness tear. At follow-up, patients with full-thickness RC tears in the affected shoulder compared with their unaffected shoulder showed similar mean ASES scores (90.9 ± 11.8 vs 97.6 ± 4.3, respectively), mean Constant scores (77.8 ± 20.3 vs 84.8 ± 7.2, respectively), and mean abduction strength (11.5 ± 5.3 lb vs 12.6 ± 4.5 lb, respectively) (P > .05).

CONCLUSION

After simultaneous arthroscopic repair of the RC and a Bankart lesion in patients after shoulder dislocations, the affected extremity had similar functional outcomes compared to the noninjured, asymptomatic side at a mean of 3 years after surgery. Persistent or recurrent RC tears involving the operative extremity were common, but they did not significantly affect functional outcomes in this small study.

摘要

背景

既往研究已对同时进行肩袖(RC)修复和上盂唇损伤修复的结果进行了调查;然而,关于急性肩关节脱位后同时进行RC修复和Bankart损伤修复的结果,文献中的信息有限。

目的

确定急性肩关节脱位后同时进行关节镜下RC修复和Bankart修复的功能及影像学结果,并将功能结果与对侧无症状肩部进行比较。

研究设计

队列研究;证据等级,3级。

方法

招募至少随访2年的连续接受关节镜下同时进行RC修复和Bankart修复的患者。所有患者均有急性肩关节脱位病史。获取美国肩肘外科医师学会(ASES)、Constant-Murley和简明健康调查(SF)-36评分。对患侧肩部也进行超声成像以评估RC的完整性。

结果

共招募了13例患者(平均年龄58.8±11.2岁;平均随访38.5±12.3个月)。在患侧与未患侧肩部的比较中,平均ASES评分(分别为89.7±12.6和95.0±6.7)、平均Constant评分(分别为80.5±18.9和86.8±7.9)或平均外展力量(分别为15.4±6.4磅和15.4±5.2磅)均无显著差异(P>.05)。SF-36身体成分总结平均分为48.4。根据超声成像,4例患者存在持续性/复发性全层撕裂,1例患者出现新的全层撕裂。在随访时,患侧肩部存在全层RC撕裂的患者与未患侧肩部相比,平均ASES评分(分别为90.9±11.8和97.6±4.3)、平均Constant评分(分别为77.8±20.3和84.8±7.2)及平均外展力量(分别为11.5±5.3磅和12.6±4.5磅)相似(P>.05)。

结论

肩关节脱位患者在关节镜下同时修复RC和Bankart损伤后,患侧肢体在术后平均3年时与未受伤的无症状侧功能结果相似。累及手术肢体的持续性或复发性RC撕裂很常见,但在这项小型研究中它们并未显著影响功能结果。

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