Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC, USA.
Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC, USA.
J Shoulder Elbow Surg. 2017 Nov;26(11):1943-1947. doi: 10.1016/j.jse.2017.04.013. Epub 2017 Jul 3.
The purpose of this study was to assess the long-term outcome of the open Bankart repair for traumatic, recurrent anterior dislocation of the shoulder by evaluation of recurrence, range of motion, return to sports, arthritis, patient satisfaction, and outcome measures.
Of 162 patients, 127 patients (mean age, 31 years) were evaluated at a mean follow-up of 17.1 years (5-24) after undergoing an open Bankart repair using suture anchors. An independent orthopedic surgeon obtained a history and examined each for range of motion. Radiographs for arthritis and osteolysis were obtained unless the patient refused. Questionnaires including return to sports and function as well as satisfaction and outcome measures were completed by all patients.
There was 1 recurrent dislocation (0.8%) and 1 recurrent subluxation (0.8%) but no pain or apprehension. All remaining shoulders were stable. Compared with the normal shoulder, there was statistical difference in external rotation in abduction and at the side as well as in internal rotation but not in forward elevation or abduction. However, no patient considered any measurable loss functionally significant. Of 107 patients who participated in sports, 98 returned to the sport; 7 of the remaining 9 discontinued for reasons other than the shoulder. There were 91 patients who agreed to radiography; 48 had normal findings, 34 had mild arthrosis, 9 had moderate arthrosis, and none had severe arthrosis. Mean postoperative outcome scores were as follows: American Shoulder and Elbow Surgeons, 93.53; Rowe, 91.41; and Western Ontario Shoulder Instability Index, 327.7. There were 125 patients who were satisfied and would undergo the procedure again.
The open Bankart procedure remains the standard by which other techniques can be measured for treatment of recurrent, traumatic anterior dislocation of the shoulder.
本研究旨在通过评估复发性、运动范围、重返运动、关节炎、患者满意度和结果测量来评估开放性 Bankart 修复治疗创伤性、复发性肩关节前脱位的长期结果。
在接受开放性 Bankart 修复术（使用缝线锚钉）治疗后，162 例患者中有 127 例（平均年龄 31 岁）接受了平均 17.1 年（5-24 年）的随访。一位独立的骨科医生获取病史并对每位患者进行运动范围检查。除非患者拒绝，否则会拍摄关节炎和骨溶解的 X 光片。所有患者均完成了包括重返运动和功能以及满意度和结果测量在内的问卷。
有 1 例（0.8%）复发性脱位和 1 例（0.8%）复发性半脱位，但无疼痛或不安。所有其余的肩膀都稳定。与正常肩膀相比，外展和侧面外旋以及内旋的角度存在统计学差异，但在前举和外展中没有差异。然而，没有患者认为任何可测量的损失在功能上具有显著意义。在 107 名参加运动的患者中，98 名重返运动；其余 9 名中有 7 名因非肩部原因停止运动。有 91 名患者同意接受 X 光检查；48 例结果正常，34 例轻度关节炎，9 例中度关节炎，无一例严重关节炎。术后平均结果评分如下：美国肩肘外科医师协会评分 93.53；Rowe 评分 91.41；和西部安大略省肩不稳定指数评分 327.7。有 125 名患者满意并愿意再次接受该手术。
开放性 Bankart 手术仍然是治疗复发性创伤性肩关节前脱位的标准，其他技术可以以此为标准进行衡量。
