3rd Orthopaedic Department Hygeia Hospital, Athens, Greece.
3rd Orthopaedic Department Hygeia Hospital, Athens, Greece.
Arthroscopy. 2021 Mar;37(3):795-803. doi: 10.1016/j.arthro.2020.10.036. Epub 2020 Oct 27.
To evaluate the clinical, functional, and radiological midterm outcomes of the all-arthroscopic modified Eden-Hybinette procedure in patients with recurrent anterior shoulder instability.
A retrospective, single-center case series with prospectively collected data was conducted. The inclusion criterion was traumatic recurrent anterior shoulder instability with significant glenoid bone loss; patients with atraumatic or multidirectional instability were excluded. An all-arthroscopic modified Eden-Hybinette procedure using iliac crest autograft and double-pair button fixation was carried out. All patients were postoperatively assessed for recurrence and apprehension. Shoulder range of motion values and functional scores, including American Shoulder and Elbow Surgeons Score, Oxford instability, Rowe instability, and Walch-Dupplay, were recorded. Graft positions, healing, and absorption were evaluated with computed tomography. Comparisons of values were performed with paired t tests for normally distributed differences and with nonparametric Wilcoxon's signed rank test otherwise.
The final study cohort included 28 patients, mean age 36 ± 10 years, and mean follow-up period 43 ± 6 months (range 36 to 53). Median glenoid bone loss was 12.4% (range 8% to 33%). No recurrence occurred, no subjective shoulder instability was reported, and no major complications were documented through the last follow-up. Postoperative shoulder range of motion had no significant differences compared with the healthy side. All final postoperative functional scores significantly increased to show excellent results compared with preoperative values. All grafts were positioned and healed optimally, and none was completely reabsorbed.
The all-arthroscopic modified Eden-Hybinette procedure is safe, leading to excellent clinical and radiological midterm outcomes in patients with recurrent anterior shoulder instability. This technique restores glenoid bone defects and preserves the normal shoulder anatomy.
IV, therapeutic, retrospective case series.
评估全关节镜下改良 Eden-Hybinette 手术治疗复发性肩关节前向不稳定的临床、功能和影像学中期结果。
这是一项回顾性、单中心病例系列研究，前瞻性收集数据。纳入标准为创伤性复发性肩关节前向不稳定伴明显盂骨缺损；排除非创伤性或多向不稳定患者。采用髂嵴自体骨移植和双对纽扣固定的全关节镜下改良 Eden-Hybinette 手术。所有患者术后均评估复发和恐惧情况。记录肩关节活动范围值和功能评分，包括美国肩肘外科医生评分、牛津不稳定评分、Rowe 不稳定评分和 Walch-Dupplay 评分。通过计算机断层扫描评估移植物位置、愈合和吸收情况。正态分布差异采用配对 t 检验，非正态分布差异采用非参数 Wilcoxon 符号秩检验进行比较。
最终研究队列包括 28 例患者，平均年龄 36±10 岁，平均随访时间 43±6 个月（范围 36 至 53 个月）。中位盂骨缺损为 12.4%（范围 8%至 33%）。末次随访时无复发，无主观肩关节不稳定，无重大并发症。术后肩关节活动范围与健侧无显著差异。所有最终术后功能评分均显著升高，与术前相比结果均为优。所有移植物均定位和愈合良好，无完全吸收。
全关节镜下改良 Eden-Hybinette 手术安全，可使复发性肩关节前向不稳定患者获得良好的临床和影像学中期结果。该技术可修复盂骨缺损，保留正常的肩关节解剖结构。
IV 级，治疗性，回顾性病例系列研究。
