Division of Orthopedic and Trauma Surgery, Department of Surgery, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PL 21, 90029 OYS, Oulu, Finland.
Knee Surg Sports Traumatol Arthrosc. 2018 Jan;26(1):94-99. doi: 10.1007/s00167-017-4504-z. Epub 2017 Mar 16.
This study investigated the long-term results of arthroscopic Bankart repair in terms of rates and timelines of recurrence of instability, with special interest in young adult patients aged ≤20 years.
Between 2000 and 2005, 186 shoulders [182 patients, 50 women, median age 26 (range 15-58) years] were operated on at a university hospital using arthroscopic Bankart repair because of instability after traumatic anteroinferior shoulder dislocation. Medical records were retrospectively reviewed and patients were assessed using postal questionnaires or telephone interview after a minimum of 10 years of follow-up [median 12.2 (range 10-16) years]. The primary outcome measure was recurrence of instability (assessed from 167 shoulders), other outcome measures included Oxford instability score (OIS), subjective shoulder value (SSV), and Western Ontario instability index (WOSI) (assessed from 157 shoulders).
At the end of follow-up, 50/167 shoulders (30%) had recurrence of instability and 30/167 (18%) were subjected to reoperation due to instability symptoms. Twenty-six (52%) failures occurred within ≤2 years, 11 (22%) within 2-5 years, and 13 (26%) >5 years after surgery. Failure rate was 19/35 (54%) for patients aged ≤20 years and 31/132 (24%) for patients aged >20 years; reoperation rates were 11/35 (31%) and 19/132 (14%), respectively. Mean OIS was 20 (SD 9, range 12-50), SSV 83% (SD 21, range 10-100), and WOSI score 80 (SD 22, range 33-100).
Nearly one-third of patients had recurrence of instability after arthroscopic Bankart repair after a minimum of 10-year follow-up. Patients aged ≤20 years did poorly with more than half of the patients having recurrence; alternative stabilization techniques should probably be considered for these patients.
IV.
本研究旨在探讨关节镜下 Bankart 修复术治疗复发性肩关节前下脱位的长期疗效，重点关注≤20 岁的年轻患者。
2000 年至 2005 年，186 例肩关节（182 例患者，50 例女性，中位年龄 26 岁（15-58 岁））在一家大学医院因创伤性前下盂肱关节脱位后出现不稳定而行关节镜下 Bankart 修复术。回顾性分析病历资料，对至少 10 年（中位时间 12.2 年，范围 10-16 年）随访的患者进行问卷调查或电话随访。主要观察指标为复发性不稳定（167 例肩关节），其他观察指标包括牛津不稳定评分（OIS）、主观肩部评分（SSV）和西部安大略不稳定指数（WOSI）（157 例肩关节）。
末次随访时，50/167 例（30%）肩关节有复发性不稳定，30/167 例（18%）因不稳定症状再次手术。26 例（52%）在≤2 年内出现失败，11 例（22%）在 2-5 年内，13 例（26%）在手术后>5 年内出现失败。≤20 岁患者的失败率为 19/35（54%），>20 岁患者的失败率为 31/132（24%）；再次手术率分别为 11/35（31%）和 19/132（14%）。平均 OIS 为 20 分（标准差 9 分，范围 12-50 分），SSV 为 83%（标准差 21%，范围 10-100%），WOSI 评分为 80 分（标准差 22 分，范围 33-100 分）。
关节镜下 Bankart 修复术后至少 10 年随访，近三分之一的患者出现复发性肩关节前下脱位。≤20 岁的患者预后较差，超过一半的患者出现复发；这些患者可能需要考虑替代的稳定技术。
IV。
