Lloyd Gregory, Day Jonathan, Lu Jana, Lincoln Andrew, Attanasio Sarah, Svoboda Steven
Medstar National Rehabilitation Hospital, Washington, DC.
Sports Med Arthrosc Rev. 2021 Jun 1;29(2):54-62. doi: 10.1097/JSA.0000000000000305.
Anterior glenohumeral instability is the most common form of shoulder instability. The systematic review summarizes the latest research on rehabilitation after Bankart repair. Inclusion criteria included postoperative rehabilitation and published in English between 2000 and 2019. Studies were excluded if they were addresses, comments, or editorials, or included other shoulder injuries or cadaver models. Two rounds of review using Rayyan QCRI software were performed for screening and full text search, and the articles were graded for levels of evidence. Of the 1982 articles, 14 articles were included with levels of evidence 1 through 4. Both arthroscopic and open Bankart repair have demonstrated improving functional outcomes and reducing recurrence rates of anterior shoulder instability. Accelerated postoperative rehabilitation may be comparable to a conventional protocol for arthroscopic repair, and the subscapularis musculature involvement during open repair can impact the timeframe. Strong evidence supports 4 phases of rehabilitation and future clinical trials are needed to compare different programs.
肩肱关节前不稳定是肩部不稳定最常见的形式。该系统评价总结了Bankart修复术后康复的最新研究。纳入标准包括2000年至2019年期间发表的英文术后康复研究。如果研究是述评、评论或社论,或包括其他肩部损伤或尸体模型,则予以排除。使用Rayyan QCRI软件进行两轮审查以进行筛选和全文检索,并对文章进行证据水平分级。在1982篇文章中,纳入了14篇证据水平为1至4级的文章。关节镜下和开放Bankart修复均已证明可改善功能结果并降低肩前不稳定的复发率。术后加速康复可能与关节镜修复的传统方案相当,开放修复期间肩胛下肌的参与会影响康复时间。有力证据支持康复的4个阶段,未来需要进行临床试验以比较不同的方案。