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关节镜下Bankart修复术治疗肩关节前向不稳:适应证与疗效

Arthroscopic Bankart Repair for the Management of Anterior Shoulder Instability: Indications and Outcomes.

作者信息

DeFroda Steven, Bokshan Steven, Stern Evan, Sullivan Kayleigh, Owens Brett D

机构信息

Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, 593 Eddy Street, Providence, RI, 02903, USA.

University Orthopedics Inc., Providence, RI, USA.

出版信息

Curr Rev Musculoskelet Med. 2017 Dec;10(4):442-451. doi: 10.1007/s12178-017-9435-2.

Abstract

PURPOSE OF REVIEW

Arthroscopic Bankart repair is commonly utilized for shoulder stabilization in patients with anterior shoulder instability with minimum glenoid bone loss. The purpose of this review is to provide the indications, surgical technique, complications, and recent outcomes in arthroscopic Bankart repair for shoulder instability.

RECENT FINDINGS

Improvements in arthroscopic techniques have led to better patient outcomes, as well as an improved understanding of the pathoanatomy of instability. More recent studies have shown that one of the potential failures of primary arthroscopic repair may be due to unaddressed bone loss. This underscores the importance of evaluating glenoid bone loss and proper patient selection for this procedure to ensure successful outcome. When indicated, arthroscopic stabilization is the treatment of choice for many surgeons due to its lower morbidity and low overall complication rate. Future work must focus on longer-term outcomes in patients undergoing arthroscopic Bankart repair, as well as the clinical outcomes of new fixation techniques, augmentation techniques, and the effect of glenoid bone loss in outcome.

摘要

综述目的

关节镜下Bankart修复术常用于治疗肩关节前向不稳且关节盂骨丢失最少的患者,以稳定肩关节。本综述旨在阐述关节镜下Bankart修复术治疗肩关节不稳的适应证、手术技术、并发症及近期疗效。

最新发现

关节镜技术的进步使患者预后更佳,同时对不稳的病理解剖也有了更深入的认识。近期研究表明,初次关节镜修复潜在失败原因之一可能是未处理的骨丢失。这凸显了评估关节盂骨丢失情况及合理选择患者进行该手术以确保成功预后的重要性。在有指征时,由于其较低的发病率和总体并发症发生率,关节镜稳定术是许多外科医生的首选治疗方法。未来的工作必须聚焦于接受关节镜下Bankart修复术患者的长期预后,以及新固定技术、增强技术的临床疗效,还有关节盂骨丢失对预后的影响。

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