Shoulder and Elbow Service, Funabashi Orthopaedic Sports Medicine and Joint Center, Funabashi, Japan.
Tokyo Sports and Orthopaedic Clinic, Tokyo, Japan.
Am J Sports Med. 2021 May;49(6):1604-1611. doi: 10.1177/03635465211003091. Epub 2021 Apr 12.
Many surgeons prefer bony stabilization including Bristow or Latarjet procedures for shoulder instability in collision athletes, even though several potential complications have been reported. There has been a limited number of studies on the midterm outcomes of arthroscopic soft tissue stabilization for anterior shoulder instability in competitive collision athletes.
To assess the outcomes of arthroscopic soft tissue stabilization in combination with selective augmentation procedures for collision athletes with traumatic anterior shoulder instability.
Case series; Level of evidence, 4.
We retrospectively assessed rugby or American football players (<40 years old) who underwent arthroscopic Bankart or bony Bankart repair with selective augmentations (rotator interval closure and/or Hill-Sachs remplissage) for traumatic anterior shoulder instability between January 2012 and March 2017. Shoulders that required other bony procedures were excluded. Recurrence, complications, return to sport, and functional scores (Rowe score and Subjective Shoulder Value sports score) were investigated.
This study included 113 shoulders in 100 patients with a mean age of 20 years (range, 15-36 years) at surgery. Rotator interval closure was performed on 36 shoulders in addition to Bankart repair, and rotator interval closure and Hill-Sachs remplissage were performed on 77 shoulders. The mean follow-up period was 44 months (range, 24-72 months). Of the 113 shoulders, 4 (3.5%) experienced postoperative dislocation, but there were no complications. A total of 93 athletes (93%) attained complete or near complete preinjury sports activity levels. The mean Rowe score significantly improved from 36 (range, 10-75) at presurgery to 96 (range, 35-100; = .003) at postsurgery. The mean Subjective Shoulder Value sports score significantly improved after surgery, from a mean preoperative score of 22 (range, 0-50) to a postoperative score of 92 (range, 64-100; = .002).
Our treatment strategy, where arthroscopic soft tissue stabilization was combined with selected augmentations, provided good clinical outcomes for competitive collision athletes in terms of low rates of recurrence and complication, a high rate of return to sports, and good shoulder function.
许多外科医生倾向于对碰撞运动员的肩关节不稳定进行骨性稳定，包括 Bristow 或 Latarjet 手术，尽管已经报道了几种潜在的并发症。对于竞技碰撞运动员的创伤性前肩不稳定，关节镜下软组织稳定的中期结果的研究数量有限。
评估关节镜下软组织稳定结合选择性增强术治疗创伤性前肩不稳定的竞技碰撞运动员的疗效。
病例系列；证据水平，4 级。
我们回顾性评估了 2012 年 1 月至 2017 年 3 月期间因创伤性前肩不稳定而行关节镜 Bankart 或骨 Bankart 修复术（包括旋转间隔闭合和/或 Hill-Sachs 填充术）的橄榄球或美式足球运动员（<40 岁）。排除需要其他骨手术的肩关节。研究内容包括复发、并发症、重返运动和功能评分（Rowe 评分和主观肩价值运动评分）。
本研究共纳入 100 例患者的 113 例肩关节，手术时的平均年龄为 20 岁（15-36 岁）。除 Bankart 修复外，36 例肩关节行旋转间隔闭合术，77 例肩关节行旋转间隔闭合和 Hill-Sachs 填充术。平均随访时间为 44 个月（24-72 个月）。113 例肩关节中，术后有 4 例（3.5%）发生脱位，但无并发症。93 例运动员（93%）完全或接近完全恢复了术前运动水平。Rowe 评分从术前的 36 分（10-75 分）显著改善至术后的 96 分（35-100 分； =.003）。术后主观肩价值运动评分显著改善，术前平均评分为 22 分（0-50 分），术后评分为 92 分（64-100 分； =.002）。
我们的治疗策略是关节镜下软组织稳定结合选择性增强术，对于竞技碰撞运动员来说，复发和并发症发生率低、重返运动率高、肩关节功能良好。
