Mittal Ravi, Jain Siddarth
Department of Orthopaedics, AIIMS, New Delhi, India.
Indian J Orthop. 2021 Apr 8;55(3):728-733. doi: 10.1007/s43465-021-00401-w. eCollection 2021 Jun.
The purpose of this study was to analyze the clinical outcomes after Eden-Hybinette procedure for revision surgery in recurrent anterior shoulder instability in patients with epilepsy.
We retrospectively evaluated eight such patients between 2015 and 2018. Four patients had failed Latarjet/Bristow procedure and two had failed arthroscopic Bankart procedure, while two had history of both the procedures. After medical control of epilepsy, Eden-Hybinette procedure was performed in all patients. WOSI score and Rowe shoulder score was recorded preoperatively and in subsequent post-operative follow-up. A paired test was used to analyze and compare preoperative and postoperative outcomes and was considered significant if value was < 0.05.
The average follow-up was 30 months (range 24-48 months). There was no recurrence of shoulder instability. The mean WOSI score before surgery was 77.3 (range 70-83), which improved to 24.2 (range 19-30) at 24-month follow-up. The mean Rowe score before surgery was 11.3 (range 5-15), which improved to 81.8(range 65-90) at 24-month follow-up. The improvement in WOSI and Rowe score was found to be statistically significant [ value < 0.05].
We conclude that Eden-Hybinette is a useful revision procedure to manage recurrent anterior shoulder dislocation in patients with epilepsy. Optimum medical control of seizure is also an important factor in preventing recurrent shoulder instability.
本研究旨在分析伊登-希比内特手术用于癫痫患者复发性前肩不稳翻修手术的临床疗效。
我们回顾性评估了2015年至2018年间的8例此类患者。4例患者的拉塔热/布里斯托手术失败,2例患者的关节镜下Bankart手术失败,另外2例患者两种手术均失败。在癫痫得到药物控制后,所有患者均接受了伊登-希比内特手术。术前及术后随访时记录WOSI评分和罗伊肩部评分。采用配对检验分析和比较术前和术后结果,若p值<0.05,则认为差异有统计学意义。
平均随访时间为30个月(范围24 - 48个月)。肩部不稳未复发。术前WOSI评分平均为77.3(范围70 - 83),在24个月随访时提高到24.2(范围19 - 30)。术前罗伊评分平均为11.3(范围5 - 15),在24个月随访时提高到81.8(范围65 - 90)。WOSI评分和罗伊评分的改善具有统计学意义[p值<0.05]。
我们得出结论,伊登-希比内特手术是治疗癫痫患者复发性前肩脱位的一种有用的翻修手术。癫痫发作的最佳药物控制也是预防肩部不稳复发的一个重要因素。