Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Ewha Womans University, School of Medicine, Seoul, Korea.
Arthroscopy. 2019 May;35(5):1351-1358. doi: 10.1016/j.arthro.2018.12.011. Epub 2019 Apr 12.
To compare the clinical outcomes and radiological findings at the anchor site after arthroscopic Bankart repair with all-suture anchors and biodegradable suture anchors in patients with recurrent anterior shoulder dislocation.
The patients who underwent arthroscopic Bankart repair were divided into 2 groups depending on the type of the suture anchor used in different periods. Power analysis was designed based on the postoperative Rowe score. Clinical outcomes, including the Rowe score, American Shoulder and Elbow Surgeons score, subjective instability, and redislocation rates were evaluated. In all patients enrolled, the tunnel diameter of the anchor was assessed with computed tomography arthrogram at 1 year postoperatively. The Institutional Review Board of Ewha Womans University approved this study (no. EUMC 2017-05-058).
A total of 67 patients were enrolled: 33 underwent surgery with a 1.3-mm (single-loaded) or 1.8-mm (double-loaded) all-suture anchor (group A), and 34 underwent surgery with a 3.0-mm biodegradable anchor (10.8 mm in length, 30% 1,2,3-trichloropropane/70% poly-lactide-co-glycolic acid) (group B). There were no significant differences in clinical outcomes between groups A and B in the American Shoulder and Elbow Surgeons score (preoperatively, 51.2 ± 13.7 vs 47.7 ± 12.2; 2 years postoperatively, 88.5 ± 12.3 vs 89.7 ± 10.9; P = .667) and Rowe score (preoperatively, 41.4 ± 10.5 vs 41.3 ± 9.4; 2 years postoperatively, 87.9 ± 14.9 vs 88.5 ± 14.6; P = .857). Postoperative redislocation (6.1% vs 5.9%, P = .682) and subjective instability rate (12.2% vs 17.7%, P = .386) of both groups showed no significant difference. Average tunnel diameter increment was significantly greater with the 1.8-mm all-suture anchor (2.8 ± 0.9 mm) than the 1.3-mm all-suture anchor (1.2 ± 0.8 mm) and 3.0-mm biodegradable anchor (0.8 ± 1.2 mm) (P < .001).
Arthroscopic Bankart repair with the all-suture anchor showed comparable clinical outcomes and postoperative stability as the conventional biodegradable suture anchor at 2 years after surgery. Tunnel diameter increment of the all-suture anchor was significantly greater than that of the biodegradable suture anchor at the 1-year computed tomography analysis. Although tunnel diameter increment was greater with the all-suture anchor, it did not influence the clinical outcomes.
Level III, retrospective comparative study.
比较关节镜下 Bankart 修复术采用全缝线锚钉和可吸收缝线锚钉治疗复发性肩关节前脱位患者的临床效果和锚钉部位的影像学结果。
根据不同时期使用缝线锚钉的类型，将接受关节镜 Bankart 修复术的患者分为 2 组。基于术后 Rowe 评分进行了功效分析。评估临床结果，包括 Rowe 评分、美国肩肘外科医生评分、主观不稳定和再脱位率。在所有入组患者中，术后 1 年采用 CT 关节造影术评估锚钉的隧道直径。延世大学附属医院伦理委员会批准了该研究（编号：EUMC 2017-05-058）。
共纳入 67 例患者：33 例接受 1.3mm（单加载）或 1.8mm（双加载）全缝线锚钉（A 组）治疗，34 例接受 3.0mm 可吸收锚钉（长 10.8mm，30% 1,2,3-三氯丙烷/70%聚乳酸-共-羟基乙酸）（B 组）治疗。A、B 两组在术后美国肩肘外科医生评分（术前，51.2±13.7 比 47.7±12.2；术后 2 年，88.5±12.3 比 89.7±10.9；P=0.667）和 Rowe 评分（术前，41.4±10.5 比 41.3±9.4；术后 2 年，87.9±14.9 比 88.5±14.6；P=0.857）方面均无显著差异。两组术后再脱位率（6.1%比 5.9%，P=0.682）和主观不稳定率（12.2%比 17.7%，P=0.386）也无显著差异。与 1.3mm 全缝线锚钉（1.2±0.8mm）和 3.0mm 可吸收锚钉（0.8±1.2mm）相比，1.8mm 全缝线锚钉的平均隧道直径增量（2.8±0.9mm）显著更大（P<0.001）。
关节镜下 Bankart 修复术采用全缝线锚钉治疗与传统可吸收缝线锚钉治疗相比，术后 2 年的临床效果和术后稳定性相当。在术后 1 年的 CT 分析中，全缝线锚钉的隧道直径增量明显大于可吸收缝线锚钉。虽然全缝线锚钉的隧道直径增量更大，但并未影响临床效果。
III 级，回顾性比较研究。
