Itoigawa Yoshiaki, Hooke Alexander W, Sperling John W, Steinmann Scott P, Zhao Kristin D, Itoi Eiji, An Kai-Nan
Division of Orthopedic Research, Mayo Clinic, Rochester, MN, USA.
Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan.
JSES Int. 2020 Jan 21;4(1):63-67. doi: 10.1016/j.jseint.2019.11.001. eCollection 2020 Mar.
The purpose was to investigate joint stability and range of motion after a Bankart repair without superior labral anterior-posterior (SLAP) repair (termed "Bankart repair") and after combined Bankart and SLAP repairs (termed "combined repair").
Eight fresh-frozen shoulders were used. Combined Bankart and SLAP lesions were created (10- to 6-o'clock positions). The labrum and capsule were repaired at the 2-o'clock, 3:30 clock-face, and 5-o'clock positions in the Bankart repair group and at the 11-o'clock, 1-o'clock, 2-o'clock, 3:30 clock-face, and 5-o'clock positions in the combined repair group. The internal- and external-rotation ranges of motion were determined with the arm positioned at 0° and 60° of glenohumeral abduction. The rotation angle was defined when a constant torque of 200 N-mm was applied. Joint stability was measured with a custom stability-testing device. The peak translational force in the anterior-posterior direction was measured with the arm at the end range of external rotation.
External rotation angles were greater at 0° and 60° of abduction in the Bankart repair group than in the combined repair group (0° of abduction, < .01; 60° of abduction, < .05). The internal rotation angle was greater at 60° of abduction in the Bankart repair group than in the combined repair group ( < .01). The stability between the 2 groups was not significantly different ( = .60).
In patients with combined Bankart and SLAP lesions and the need for a wide range of motion, a Bankart repair alone may provide a greater range of motion without compromising the joint stability at the end range compared with a combined repair.
本研究旨在调查单纯Bankart修复术(不进行上盂唇前后部[S-LAP]修复,称为“Bankart修复术”)以及联合Bankart和SLAP修复术(称为“联合修复术”)后关节的稳定性和活动范围。
使用8个新鲜冷冻的肩关节。制造联合的Bankart和SLAP损伤(位于10点至6点位置)。在Bankart修复组的2点、3:30钟面和5点位置以及联合修复组的11点、1点、2点、3:30钟面和5点位置修复盂唇和关节囊。在内收角度为0°和60°时,确定内外旋转活动范围。当施加200N-mm的恒定扭矩时定义旋转角度。使用定制的稳定性测试装置测量关节稳定性。在外旋末端范围时,测量手臂在前后方向上的最大平移力。
Bankart修复组在外展0°和60°时的外旋角度大于联合修复组(外展0°时,P<0.01;外展60°时,P<0.05)。Bankart修复组在外展60°时的内旋角度大于联合修复组(P<0.01)。两组之间的稳定性无显著差异(P=0.60)。
对于合并Bankart和SLAP损伤且需要较大活动范围的患者,与联合修复相比,单纯Bankart修复术可能提供更大的活动范围,且不影响关节末端范围的稳定性。