Maalouly Joseph, Aouad Dany, Darwish Mohammad, Saidy Elias, Abdelnour Hicham, Hanna Robert, Rassi Georges El
St Georges University Medical Center, Beirut, Achrafieh, St Georges Street, Lebanon.
Int J Surg Case Rep. 2020;74:177-181. doi: 10.1016/j.ijscr.2020.07.061. Epub 2020 Jul 31.
This study evaluates outcomes of a consistent arthroscopic stabilization technique for recurrent posterior instability.
79 shoulders with symptomatic posterior instability treated with arthroscopic repair and evaluated at a follow-up of 36 months. The mean age was 25.4 years of which 66 males and 13 females, and in 75% the dominant shoulder was affected. A known traumatic injury had occurred in 80%, with 25% having a documented dislocation. Arthroscopic repair was performed through an anterosuperior 12 O'clock viewing portal. Suture anchor repairs were performed in 60 cases and plication to the intact labrum in 19. A shoulder immobilizer was used for 4 weeks, followed by progressive range of motion, weightlifting at 3 months and return to contact sports at 6 months. The 79 cases had complete pre-op and post-op shoulder outcome scores.
Significant improvement from preoperatively to final follow-up was seen for ASES scores, from 58 to 93. All patients returned to their previous level of athletic activity. Two patients reported postoperative instability; none required reoperation. There were no other postoperative complications.
This study represents a consecutive series of patients with recurrent posterior instability undergoing arthroscopic posterior stabilization. In this population arthroscopic posterior labral repair and capsular plication provided significant clinical improvement with low recurrence and revision rate.
本研究评估一种用于复发性后方不稳定的一致性关节镜稳定技术的疗效。
79例有症状的后方不稳定肩关节接受关节镜修复治疗，并在36个月的随访中进行评估。平均年龄为25.4岁，其中男性66例，女性13例，75%的优势肩受累。80%发生过已知的创伤性损伤，25%有脱位记录。通过前上方12点观察入口进行关节镜修复。60例采用缝线锚钉修复，19例对完整的盂唇进行折叠缝合。使用肩部固定器4周，随后逐步进行活动范围训练，3个月时开始举重，6个月时恢复接触性运动。79例患者术前和术后均有完整的肩部疗效评分。
ASES评分从术前到最终随访有显著改善，从58分提高到93分。所有患者均恢复到术前的运动水平。2例患者报告术后不稳定；无人需要再次手术。无其他术后并发症。
本研究是一系列接受关节镜后方稳定治疗的复发性后方不稳定患者的连续病例。在这一人群中，关节镜下后方盂唇修复和关节囊折叠缝合可显著改善临床症状，复发率和翻修率低。
