Rhee Yong Girl, Cho Nam Su, Yoo Jae Hyun, Lee Won Gyu
Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, South Korea.
Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, South Korea.
J Shoulder Elbow Surg. 2015 Apr;24(4):613-20. doi: 10.1016/j.jse.2014.08.024. Epub 2014 Oct 25.
The purpose of this study was to evaluate and to grade the extent of filling into the Hill-Sachs lesion quantitatively by use of magnetic resonance arthrography after an arthroscopic remplissage procedure.
The current study enrolled 23 patients who underwent arthroscopic Bankart repair with a remplissage procedure for a large or engaging Hill-Sachs lesion confirmed by arthroscopic findings. The postoperative filling index was classified into 5 categories by axial and sagittal views of T2-weighted images on magnetic resonance arthrography: complete filling (4 points); partial filling with minor defect (3 points); partial filling with major defect (2 points); minimal filling with significant free fluid level (1 point); and filling failure with dehiscence (0 point). Filling Index Score of Remplissage (FISOR) was also calculated from the total sum of points in the axial and sagittal planes and classified into 5 grades.
The FISOR was 8 points in 13 patients, 7 points in 2 patients, 6 points in 3 patients, 5 points in 1 patient, 4 points in 1 patient, 3 points in 1 patient, 2 points in 1 patient, and 0 point in 1 patient. According to the FISOR grades, these results were recorded as excellent in 15 patients (65.2%), good in 4 patients (17.4%), fair in 2 patients (8.7%), poor in 1 patient (4.3%), and no evidence of filling in 1 patient (4.3%).
The FISOR would be a useful measurement tool for the evaluation of structural outcomes after the remplissage procedure.
本研究的目的是通过关节镜下 remplissage 手术后的磁共振关节造影定量评估并分级填充 Hill-Sachs 损伤的程度。
本研究纳入了 23 例患者,这些患者因关节镜检查发现大的或嵌顿性 Hill-Sachs 损伤而接受了关节镜下 Bankart 修复术及 remplissage 手术。术后填充指数通过磁共振关节造影 T2 加权图像的轴位和矢状位视图分为 5 类:完全填充(4 分);部分填充且有小缺损(3 分);部分填充且有大缺损(2 分);最小填充且有明显游离液平面(1 分);填充失败且有裂开(0 分)。还根据轴位和矢状位平面得分总和计算了 remplissage 填充指数评分(FISOR),并分为 5 级。
13 例患者的 FISOR 为 8 分,2 例患者为 7 分,3 例患者为 6 分,1 例患者为 5 分,1 例患者为 4 分,1 例患者为 3 分,1 例患者为 2 分,1 例患者为 0 分。根据 FISOR 分级,这些结果记录为 15 例患者(65.2%)为优秀,4 例患者(17.4%)为良好,2 例患者(8.7%)为中等,1 例患者(4.3%)为差,1 例患者(4.3%)无填充证据。
FISOR 将是评估 remplissage 手术后结构结果的有用测量工具。