Aydin Nuri, Unal Mehmet Bekir, Asansu Mustafa, Tok Okan
1 Department of Orthopedics and Traumatology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
2 Department of Orthopedics and Traumatology, Marmara University, Istanbul, Turkey.
J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017718952. doi: 10.1177/2309499017718952.
Prior studies revealed the presence of superior labrum anterior-to-posterior (SLAP) injury together with Bankart lesions in some patients. The purpose of the study is to compare the clinical results of isolated Bankart repairs with the clinical results of Bankart repairs when performed with concomitant SLAP repairs.
The patients who underwent arthroscopic surgery for treatment of anterior glenohumeral instability were evaluated retrospectively. Group 1 consisted of 19 patients who had arthroscopic SLAP repair together with Bankart repair. The mean age of the patients was 23. Group 2 consisted of 38 patients who underwent isolated Bankart repair. The mean age was 24. Knotless anchors were used in both groups.
The mean follow-up was 34 months (range: 26-72). In group 1, the mean preoperative Constant score was 84 (range: 74-90, standard deviation (SD): 5.91) and Rowe score was 64.1 (range: 40-70, SD: 8.14). In group 2, the preoperative Constant score was 84.4 (range: 70-96, SD: 5.88) and Rowe score was 60 (range: 45-70, SD: 7.95). In group 1, the postoperative mean Constant score raised to 96.8 (range: 88-100, SD: 2.91) and the mean Rowe score raised to 92.3 (range: 85-100, SD: 5.17). In group 2, the postoperative mean Constant score was 94.9 (range: 88-100, SD: 3.70) and the mean Rowe score was 94.2 (range: 80-100, SD: 4.71). The difference between the scores of two groups was insignificant ( p > 0.05). When the numbers of redislocations and range of motion were compared, no significant difference was found ( p > 0.05).
Accompanying SLAP repair in surgical treatment with Bankart repair for shoulder instability does not affect the results negatively. Properly repaired labral tears extending from anterior inferior to the posterior superior of the glenoid in instability treatment have the same outcome in overall results as repaired isolated Bankart lesions.
先前的研究显示,部分患者存在上盂唇前向至后向(SLAP)损伤合并Bankart损伤。本研究的目的是比较单纯Bankart修复术与同时进行SLAP修复的Bankart修复术的临床效果。
对接受关节镜手术治疗前盂肱关节不稳的患者进行回顾性评估。第1组由19例行关节镜下SLAP修复联合Bankart修复的患者组成。患者的平均年龄为23岁。第2组由38例行单纯Bankart修复的患者组成。平均年龄为24岁。两组均使用无结锚钉。
平均随访34个月(范围:26 - 72个月)。在第1组中,术前平均Constant评分84分(范围:74 - 90分,标准差(SD):5.91),Rowe评分64.1分(范围:40 - 70分,SD:8.14)。在第2组中,术前Constant评分84.4分(范围:70 - 96分,SD:5.88),Rowe评分60分(范围:45 - 70分,SD:7.95)。在第1组中,术后平均Constant评分升至96.8分(范围:88 - 100分,SD:2.91),平均Rowe评分升至92.3分(范围:85 - 100分,SD:5.17)。在第2组中,术后平均Constant评分94.9分(范围:88 - 100分,SD:3.70),平均Rowe评分94.2分(范围:80 - 100分,SD:4.71)。两组评分差异无统计学意义(p > 0.05)。比较再脱位次数和活动范围时,未发现显著差异(p > 0.05)。
在Bankart修复术治疗肩部不稳时同时进行SLAP修复术不会对结果产生负面影响。在不稳治疗中,从关节盂前下延伸至后上的唇盂撕裂伤进行适当修复后,总体结果与单纯Bankart损伤修复相同。