Steadman Philippon Research Institute, Vail, Colorado, USA.
The Steadman Clinic, Vail, Colorado, USA.
Am J Sports Med. 2019 Jan;47(1):158-164. doi: 10.1177/0363546518808495. Epub 2018 Nov 28.
The arthroscopic "bony Bankart bridge" (BBB) repair technique was recently shown to successfully restore shoulder stability at short-term follow-up, but longer-term outcomes have not yet been described.
To report the outcomes at minimum 5-year follow-up after BBB repair for anterior shoulder instability with a bony Bankart lesion.
Case series; Level of evidence, 4.
Patients were included if they sustained a bony Bankart lesion, were treated with a BBB technique, and were at least 5 years postoperative. Patients were excluded if they underwent concomitant rotator cuff repair or an open bone fragment reduction. All patients were assessed with the following measures preoperatively and at final evaluation: QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand), American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and 12-Item Short Form Health Survey (SF-12) Physical Component Summary.
From 2008 to 2012, 13 patients who underwent BBB met the inclusion criteria with a mean age of 39.6 years (range, 19.1-68.8 years) and a mean follow-up of 6.7 years (range, 5.1-9.0 years). Mean time from most recent injury to surgery was 6.3 months (range, 1 day-36 months). The mean glenoid bone loss was 22.5% (range, 9.1%-38.6%). Mean SF-12 scores demonstrated significant improvement from 45.8 (SD, 9.7) preoperatively to 55.1 (SD, 5.9) at a mean follow-up of 6.7 years. At final follow-up, the mean American Shoulder and Elbow Surgeons score was 93.1 (range, 68.3-100); the mean QuickDASH score, 6.2 (range, 0-25); and the mean Single Assessment Numeric Evaluation score, 92.8 (range, 69-99). None of the patients progressed to further shoulder surgery. Three of 13 patients (23%) reported subjective recurrent instability. At final follow-up, 9 of 12 (75%) patients indicated that their sports participation levels were equal to their preinjury levels. Median patient satisfaction at final follow-up was 10 of 10 points (range, 3-10).
The arthroscopic BBB technique for patients with anterior bony Bankart lesions can restore shoulder stability, yield durable improvements in clinical outcomes, and provide a high return-to-sport rate at a minimum 5-year follow-up. Three of 13 patients experienced postoperative symptoms of instability but did not undergo further stabilization surgery.
关节镜下“骨性 Bankart 桥”（BBB）修复技术近期在短期随访中成功恢复了肩关节稳定性，但尚未描述其长期结果。
报告采用骨性 Bankart 修复技术治疗前肩不稳伴骨性 Bankart 损伤的患者至少 5 年的随访结果。
病例系列；证据等级，4 级。
纳入标准为存在骨性 Bankart 损伤、接受 BBB 技术治疗且术后至少 5 年的患者。排除标准为同时接受肩袖修复或开放性骨块复位的患者。所有患者术前和最终评估时均采用以下测量方法进行评估：快速残疾量表（QuickDASH）、美国肩肘外科医师协会评分、单一评估数字评估和 12 项简明健康调查量表（SF-12）生理成分综合评分。
2008 年至 2012 年间，符合纳入标准的 13 例患者接受 BBB 治疗，平均年龄为 39.6 岁（19.168.8 岁），平均随访时间为 6.7 年（5.19.0 年）。最近一次损伤至手术的平均时间为 6.3 个月（1 天36 个月）。平均盂肱关节骨丢失率为 22.5%（9.1%38.6%）。SF-12 评分平均从术前的 45.8（标准差 9.7）显著改善至 6.7 年时的 55.1（标准差 5.9）。最终随访时，美国肩肘外科医师协会评分平均为 93.1（68.3100）；QuickDASH 评分平均为 6.2（025）；单一评估数字评估评分平均为 92.8（6999）。无患者进展为进一步的肩部手术。13 例患者中有 3 例（23%）报告有主观复发性不稳定。最终随访时，12 例患者中有 9 例（75%）表示其运动参与水平与受伤前相同。最终随访时，患者满意度中位数为 10 分（310 分）。
对于前骨性 Bankart 病变患者，关节镜下 BBB 技术可恢复肩关节稳定性，临床结果持久改善，并在至少 5 年的随访中提供高的重返运动率。13 例患者中有 3 例术后出现不稳定症状，但未行进一步稳定手术。
