Saper Michael G, Milchteim Charles, Zondervan Robert L, Andrews James R, Ostrander Roger V
The Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, Florida, USA.
Orlin & Cohen Orthopedic Group, Woodbury, New York, USA.
Orthop J Sports Med. 2017 Mar 28;5(3):2325967117697950. doi: 10.1177/2325967117697950. eCollection 2017 Mar.
Literature on arthroscopic stabilization in adolescent patients participating in collision and contact sports is limited, as most studies include adolescents within a larger sample group comprised primarily of adults.
To review the outcomes of arthroscopic Bankart repair for anterior shoulder instability in an adolescent population participating in collision and contact sports.
Case series; Level of evidence, 4.
This retrospective review included 39 shoulders in 37 adolescent (≤19 years) athletes who underwent primary arthroscopic Bankart repair using suture anchors with at least 2-year follow-up. All patients had a history of trauma to their shoulder resulting in an anterior dislocation. Outcome measures included patient satisfaction, the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Rowe score. Recurrence of dislocation and return to sporting activity were also assessed.
The mean age at the time of surgery was 16.9 years (range, 15-19 years), and the mean follow-up was 6.3 years (range, 4.3-10.0 years); 58.6% of patients participated in collision sports. Time to surgery after the initial dislocation episode was 9.2 months (range, 0.5-36.2 months). Four shoulders (10.3%) had dislocation events postoperatively. The majority (78.1%) of patients returned to sports at the same level of competition. Mean VAS was 0.49 ± 1.0, and the mean ASES and Rowe scores were 92.8 ± 12.6 and 85.0 ± 24.2, respectively. Univariate analyses demonstrated that subjective functional outcomes were negatively correlated with recurrence (ASES, = .005; Rowe, = .001) and failure to return to sport (ASES, = .016; Rowe, = .004). Independent variables shown to have no significant relationship to functional outcomes included age, follow-up, number of preoperative dislocations, time to surgery, sport classification, competition level, tear extent, number of anchors, concurrent Hill-Sachs lesion, and repair of a superior labral anterior-posterior (SLAP) lesion.
Arthroscopic Bankart repair is an effective surgical option for traumatic shoulder instability in adolescents participating in collision and contact sports. At a minimum 4-year follow-up, arthroscopic Bankart repair effectively restored stability in 90% of cases; 80% returned to their preinjury level of sport.
关于青少年参与碰撞和接触性运动的关节镜稳定手术的文献有限，因为大多数研究纳入的青少年是在主要由成年人组成的更大样本组中。
回顾在参与碰撞和接触性运动的青少年人群中，关节镜下Bankart修复治疗前肩不稳的疗效。
病例系列；证据等级，4级。
这项回顾性研究纳入了37名年龄≤19岁的青少年运动员的39个肩部，这些患者接受了使用缝线锚钉的初次关节镜下Bankart修复，且随访至少2年。所有患者均有肩部外伤史并导致前脱位。结局指标包括患者满意度、疼痛视觉模拟量表（VAS）、美国肩肘外科医师（ASES）评分和Rowe评分。还评估了脱位复发情况和恢复运动情况。
手术时的平均年龄为16.9岁（范围15 - 19岁），平均随访时间为6.3年（范围4.3 - 10.0年）；58.6%的患者参与碰撞性运动。初次脱位事件后至手术的时间为9.2个月（范围0.5 - 36.2个月）。4个肩部（10.3%）术后发生脱位事件。大多数患者（78.1%）恢复到受伤前的运动水平。平均VAS为0.49±1.0，平均ASES和Rowe评分分别为92.8±12.6和85.0±24.2。单因素分析表明，主观功能结局与复发（ASES，P = 0.005；Rowe，P = 0.001）以及未能恢复运动（ASES，P = 0.016；Rowe，P = 0.004）呈负相关。与功能结局无显著关系的独立变量包括年龄、随访时间、术前脱位次数、手术时间、运动分类、比赛水平、撕裂程度、锚钉数量、并发的Hill-Sachs损伤以及上盂唇前后（SLAP）损伤的修复情况。
关节镜下Bankart修复是参与碰撞和接触性运动的青少年创伤性肩不稳的一种有效手术选择。在至少4年的随访中，关节镜下Bankart修复在90%的病例中有效恢复了稳定性；80%的患者恢复到受伤前的运动水平。
