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关节镜下Bankart修复术治疗复发性创伤性肩关节前脱位的早期疗效

Early outcome of arthroscopic Bankart's repair for recurrent traumatic anterior shoulder instability.

作者信息

Saccomanni Bernardino

机构信息

Ambulatorio di Ortopedia, Via della Conciliazione, 65, CAP 74014 Laterza (TA), Italy ; Orthopaedic and Trauma Surgery, Viale Regina Margherita, 70022 Altamura (BARI), Italy.

出版信息

J Clin Orthop Trauma. 2013 Sep;4(3):129-34. doi: 10.1016/j.jcot.2013.05.001. Epub 2013 Jun 4.

Abstract

BACKGROUND/OBJECTIVES: Despite the improvements in the methods of arthroscopic stabilization of anterior shoulder instability, a recurrence rate of as high as 30% is reported in the literature. In this context, we report the outcome of arthroscopic Bankart repair in anterior shoulder instability, with the use of bio-absorbable suture anchors for patients that were followed up for at least two years from the date of surgery. The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. We would like to report the 2-year clinical outcomes of bio-absorbable suture anchors used in traumatic anterior dislocations of the shoulder.

METHODS

Data from 79 shoulders in 74 patients were collected over 4 years (2005-2009). Each patient was followed up over a period of 2 years. The patients underwent arthroscopic Bankart repair using bio-absorbable suture anchors for their anterior shoulder instability. These surgeries were performed at a single institution by a single surgeon over the time period. The patients were assessed with two different outcome measurement tools. The University of California at Los Angeles (UCLA) shoulder rating scale and the Simple Shoulder Test (SST) score. The scores were calculated before surgery and at the 2-year follow-up. The recurrence rates, range of motion as well post-operative function and return to sporting activities were evaluated.

RESULTS

SST results from the 12 domains showed a significant improvement from a mean of 6.1 ± 3.1 to 11.1 ± 1.8 taken at the 2-year follow-up (p < 0.0001). Data from the UCLA scale showed a pre and post-operative mean of 20.2 ± 5.0 and 32.4 ± 4.6 respectively (p < 0.0001). 34 had excellent post-operative scores, 35 had good scores, 1 had fair score and 3 had poor scores. 75% of the patients returned to sports while 7.6% developed a recurrence of shoulder dislocation or subluxation.

CONCLUSION

Arthroscopic Bankart repair with the use of suture anchors is a reliable treatment method, with good clinical outcomes, excellent post-operative shoulder motion and low recurrence rates.

摘要

背景/目的:尽管肩关节前不稳定的关节镜稳定技术有所改进,但文献报道其复发率高达30%。在此背景下,我们报告了使用生物可吸收缝线锚钉进行关节镜下Bankart修复治疗肩关节前不稳定的结果,这些患者自手术日期起至少随访了两年。关节镜方法为创伤性肩关节前不稳定的Bankart修复提供了一种侵入性较小的技术。我们想报告生物可吸收缝线锚钉用于创伤性肩关节前脱位的2年临床结果。

方法

在4年(2005 - 2009年)期间收集了74例患者79个肩关节的数据。每位患者随访2年。患者因肩关节前不稳定接受了使用生物可吸收缝线锚钉的关节镜下Bankart修复。这些手术在同一机构由同一位外科医生在该时间段内完成。使用两种不同的结果测量工具对患者进行评估。即加利福尼亚大学洛杉矶分校(UCLA)肩关节评分量表和简单肩关节测试(SST)评分。在手术前和2年随访时计算得分。评估复发率、活动范围以及术后功能和恢复体育活动的情况。

结果

12个领域的SST结果显示,从平均6.1±3.1显著改善至2年随访时的11.1±1.8(p < 0.0001)。UCLA量表数据显示术前和术后平均值分别为20.2±5.0和32.4±4.6(p < 0.0001)。34例术后评分优秀,35例良好,1例中等,3例差。75%的患者恢复了运动,而7.6%出现了肩关节脱位或半脱位复发。

结论

使用缝线锚钉的关节镜下Bankart修复是一种可靠的治疗方法,临床效果良好,术后肩关节活动优秀,复发率低。

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