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在复发性肩关节脱位中,使用单前入路和标准双入路技术可获得相似的功能结果。

Similar functional outcome using single anterior portal and standard two portals technique in recurrent dislocation of shoulder.

作者信息

Ghai Amresh, Sachdeva Julie, Sood Munish, Sud Ajaydeep, Chauhan Monika, Singh Shalendra

机构信息

Department of Orthopaedics, Base Hospital, Delhi Cantt 110010, India.

Command Hospital (WC), Chandimandir 134107, India.

出版信息

Chin J Traumatol. 2020 Apr;23(2):102-106. doi: 10.1016/j.cjtee.2019.12.003. Epub 2020 Jan 24.

Abstract

PURPOSE

Recurrent dislocation of shoulder (RDS) is a common injury in high demand professionals, like athletes and military personnel. The treatment for the patients with Bankart lesion is the arthroscopic repair. This present study compares the outcomes of two different techniques of arthroscopic Bankart repair i.e. a standard two anterior portals technique and a single anterior portal technique in patients with RDS.

METHODS

Patients with traumatic RDS met the inclusion criteria were managed with Bankart repair using either two anterior portals (Group A) or a single anterior portal (Group B) technique. Patients were evaluated before the intervention and at the mean follow-up of approximately two years using Rowe score, Oxford shoulder score and Tegner activity scale.

RESULTS

The mean age of the patients in Groups A (n = 34) and B (n = 37) was 29.64 years and 29.05 years respectively (p = 0.66). The dominant shoulder was involved in 27 patients in Group A and 22 patients in Group B (p = 0.069). The operative time in Group A and B was 68.52 min and 46.35 min, respectively (p < 0.001). The complications at follow-up, the mean Rowe score and Oxford score improved significantly in both groups compared with the pre-operative values. However, the final outcome scores were not significantly different between the both groups. The median Tegner's score preoperatively and at follow-up was 7 and 6, respectively in Groups A and B.

CONCLUSIONS

Single anterior portal technique is an effective treatment modality, yielding a similar outcome as two anterior portals technique in the management of RDS.

摘要

目的

复发性肩关节脱位(RDS)在运动员和军事人员等高需求职业人群中是一种常见损伤。对于存在Bankart损伤的患者,治疗方法是关节镜修复术。本研究比较了两种不同的关节镜下Bankart修复技术,即标准双前入路技术和单前入路技术在RDS患者中的治疗效果。

方法

符合纳入标准的创伤性RDS患者采用双前入路(A组)或单前入路(B组)技术进行Bankart修复。在干预前及平均约两年的随访时,使用Rowe评分、牛津肩关节评分和Tegner活动量表对患者进行评估。

结果

A组(n = 34)和B组(n = 37)患者的平均年龄分别为29.64岁和29.05岁(p = 0.66)。A组27例患者和B组22例患者的患侧为优势肩(p = 0.069)。A组和B组的手术时间分别为68.52分钟和46.35分钟(p < 0.001)。随访时的并发症方面,两组的平均Rowe评分和牛津评分与术前值相比均显著改善。然而,两组的最终结局评分无显著差异。A组和B组术前及随访时Tegner评分的中位数分别为7和6。

结论

单前入路技术是一种有效的治疗方式,在RDS的治疗中与双前入路技术效果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a7e/7156882/c10efd383662/gr1.jpg

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