Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey.
Department of Orthopedics and Traumatology, TOBB ETU Faculty of Medicine, Ankara, Turkey.
J Orthop Sci. 2021 Jul;26(4):584-588. doi: 10.1016/j.jos.2020.05.005. Epub 2020 Jun 26.
Accompanying injuries are frequently seen in middle aged patients with recurrent instability. The aim of this study was to elucidate the associated injuries, report patient outcomes of the following arthroscopic instability surgery regarding 40-60 years old patients with recurrent shoulder instability.
Patients that underwent arthroscopic instability surgery due to recurrent shoulder instability between February 2008 and November 2015, and which were 40-60 years old were included and evaluated retrospectively. Minimum follow-up duration was 24 months. Anterior-inferior labral injuries and accompanying pathologies such as rotator cuff tears and SLAP lesions were documented. Postoperative patient-reported outcome evaluation was made using Oxford Shoulder Instability Score.
Among 355 patients that underwent arthroscopic instability surgery, 88 patients which had pathology of recurrent instability were in the range of 40-60 years old. Patients who had previous shoulder surgery or fracture (n = 8) epileptic seizure history (n = 3), neurologic deficit (n = 2) were excluded from the study. 75 patients were included with a mean follow-up 69 ± 23 months (32-125). The percentage of middle-aged and elderly (40-60 years old) was 24.8% among recurrent shoulder instability patients. 44% had isolated Bankart lesion whereas 56% revealed multiple pathologies. Bankart + SLAP lesions were found in 32%, whereas Bankart + Rotator Cuff tears in 26.7% (13 isolated supraspinatus, 4 supraspinatus + subscapularis, 1 isolated subscapularis full-thickness and 2 partial-thickness supraspinatus tears). The mean Oxford Shoulder Instability Score was 38.4 ± 5.2 (26-48). The scores of patients which were treated with labrum and rotator cuff repair (median 42, range 30-48) were significantly better than the patients who were treated with isolated labrum repair (median 39, range 20-46) (p = 0.015). There was no difference regarding patients with or without SLAP repair (median 39 vs 39 and range 30-48 vs 20-48, respectively) (p = 0.702).
Arthroscopic repair of capsulolabral lesions is a safe and successful technique in 40-60 years old patients. Furthermore, the presence of repaired rotator cuff tears led to even superior results. Accompanying SLAP lesions did not affect the results.
Retrospective Case Series.
4, Retrospective Case Series.
复发性不稳定的中年患者常伴有伴随损伤。本研究旨在阐明相关损伤，并报告以下针对 40-60 岁复发性肩关节不稳定患者进行的关节镜下不稳定手术的患者结局。
回顾性纳入 2008 年 2 月至 2015 年 11 月期间因复发性肩关节不稳定而行关节镜下不稳定手术且年龄在 40-60 岁的患者，并进行评估。随访时间至少为 24 个月。记录前下盂唇损伤和伴随的病变，如肩袖撕裂和 SLAP 病变。使用牛津肩关节不稳定评分进行术后患者报告的结果评估。
在 355 例接受关节镜下不稳定手术的患者中，有 88 例有复发性不稳定的病理改变，年龄在 40-60 岁之间。排除了有既往肩部手术或骨折史（n=8）、癫痫发作史（n=3）、神经功能缺损史（n=2）的患者。共纳入 75 例患者，平均随访 69±23 个月（32-125）。复发性肩关节不稳定患者中，中年和老年（40-60 岁）患者占 24.8%。44%的患者存在孤立性 Bankart 病变，56%的患者存在多种病变。Bankart+SLAP 病变见于 32%的患者，Bankart+肩袖撕裂见于 26.7%的患者（13 例单纯冈上肌撕裂，4 例冈上肌+肩胛下肌撕裂，1 例肩胛下肌全层撕裂，2 例冈上肌部分撕裂）。牛津肩关节不稳定评分平均为 38.4±5.2（26-48）。接受盂唇和肩袖修复的患者（中位数 42，范围 30-48）的评分明显优于仅接受盂唇修复的患者（中位数 39，范围 20-46）（p=0.015）。接受或未接受 SLAP 修复的患者之间无差异（中位数 39 比 39，范围 30 比 30-48 比 20-48，分别）（p=0.702）。
在 40-60 岁的患者中，关节囊盂唇病变的关节镜修复是一种安全且有效的技术。此外，修复的肩袖撕裂可带来更好的效果。伴随的 SLAP 病变不影响结果。
回顾性病例系列。
4，回顾性病例系列。
