Bhatia Hospital, Mumbai, India.
Bhatia Hospital, Mumbai, India.
Arthroscopy. 2021 Mar;37(3):837-842. doi: 10.1016/j.arthro.2020.11.042. Epub 2020 Nov 26.
To determine whether curettage of the cartilage on the glenoid edge in arthroscopic Bankart repair reduces the postoperative recurrence rate compared with noncuretted glenoid.
Between January 2010 and December 2013, 134 patients underwent arthroscopy and stabilization for recurrent anterior dislocation of shoulder; 42 patients were excluded. Alternate glenoid edge was curetted in 92 patients undergoing arthroscopic Bankart repair. Twelve patients were lost to follow-up. The remaining 80 patients were divided into 2 groups of 40 patients each, curettage and noncurettage. In both groups, the Bankart lesion was repaired using ≥3 bioanchors loaded with nonabsorbable braided sutures. Postoperative rehabilitation was the same for the 2 groups. We recorded recurrence of instability, pain, and Constant and Rowe shoulder scores. Statistical analysis of data was performed using unpaired t test (significance level P < .05).
The 2 groups were comparable in terms of age, number of dislocations, and bone loss. The average follow-up was 7 years and 9 months (range 6 to 10 years). Of the total 40 patients in the curettage group, 6 (15%) had recurrence of dislocation and none had subluxations, whereas in the noncurettage group, 13 (32.5%) had recurrence of dislocation and 3 (7.5%) had subluxations. The difference in postoperative recurrence of instability was statistically significant (P = .012). The average (standard deviation) Rowe score was 83.75 (23.28) in the curettage group and 70.13 (31.29) in the noncurettage group (P = .030).
During arthroscopic Bankart repair, curettage of the cartilage on the anterior glenoid edge reduces the incidence of postoperative recurrence of instability.
II, therapeutic; prospective, randomized, controlled study.
确定关节镜下 Bankart 修复术中切除肩胛盂缘软骨是否会降低术后复发率，与未切除肩胛盂相比。
2010 年 1 月至 2013 年 12 月，134 例复发性肩关节前脱位患者接受关节镜和固定术；排除 42 例患者。92 例接受关节镜下 Bankart 修复术的患者交替切除肩胛盂缘。12 例患者失访。其余 80 例患者分为 2 组，每组 40 例，分别为切除组和未切除组。两组均采用≥3 个生物锚钉加载不可吸收编织缝线修复 Bankart 病变。两组的术后康复相同。我们记录了不稳定、疼痛、Constant 和 Rowe 肩部评分的复发情况。使用配对 t 检验对数据进行统计学分析（显著性水平 P <.05）。
两组在年龄、脱位次数和骨丢失方面具有可比性。平均随访时间为 7 年 9 个月（6 至 10 年）。切除组 40 例患者中，有 6 例（15%）出现复发性脱位，无一例出现半脱位；而在未切除组，有 13 例（32.5%）出现复发性脱位，3 例（7.5%）出现半脱位。术后不稳定的复发差异具有统计学意义（P =.012）。切除组的平均（标准差）Rowe 评分为 83.75（23.28），未切除组为 70.13（31.29）（P =.030）。
在关节镜下 Bankart 修复术中，切除肩胛盂前缘软骨可降低术后不稳定的复发率。
II，治疗性；前瞻性，随机，对照研究。
