Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.
Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul, Korea.
Clin Orthop Surg. 2021 Jun;13(2):229-236. doi: 10.4055/cios20024. Epub 2020 Dec 21.
Changes in perianchor cysts around the all-suture anchors, which demonstrate distinguished features from the biocomposite anchors, have not been revealed sufficiently. The purpose of this study was to investigate serial changes of perianchor cysts according to the location of the inserted anchor in the glenoid in arthroscopic labral repair using all-suture anchors.
We enrolled 43 patients who underwent computed tomography (CT) immediately postoperatively and CT arthrogram (CTA) at 1 year or 2 years after arthroscopic labral repair using a 1.3-mm all-suture anchor for recurrent anterior shoulder dislocation with or without a superior labral tear from anterior to posterior and a posterior labral tear. The mean diameter and tissue density (HU) of perianchor cysts were measured depending on the location in the glenoid. Clinical outcomes, labral healing, and redislocation rate were evaluated at 2 years after surgery.
On functional assessment, the mean American Shoulder and Elbow Surgeons score and Rowe score improved statistically significantly after surgery (from 47.9 ± 14.3 preoperatively to 90.1 ± 9.6 postoperatively and from 45.3 ± 12.4 preoperatively to 92.2 ± 10.1 postoperatively, respectively; < 0.01). Postoperative redislocations were found in 2 patients (4.7%). In radiological evaluation, the mean diameter of perianchor cysts at postoperative 1 year (3.24 ± 0.65 mm) was significantly larger than the immediate postoperative diameter; however, there was no significant difference between postoperative 1 year and 2 years (3.23 ± 0.57 mm). Tissue density at the center of cysts demonstrated no significant difference between 1 and 2 year postoperatively (107.7 ± 29.8 HU [superior], 99.7 ± 31.7 HU [anteroinferior], and 105.1 ± 25.0 HU [posterior] vs. 109.1 ± 26.1 HU [superior], 106.4 ± 30.3 HU [anteroinferior], and 111.0 ± 32.9 HU [posterior]). The mean diameter of perianchor cysts in the anteroinferior position was largest compared with that in superior or posterior positions.
Perianchor cysts associated with all-suture anchors enlarged significantly within 1 year after arthroscopic labral repair regardless of the insertion location in the glenoid. However, the size and tissue density of perianchor cysts were similar at postoperative 1 and 2 years, and satisfactory stability and clinical outcomes were obtained.
全缝线锚钉周围的盂唇下囊肿变化与生物复合材料锚钉不同,但其变化尚未充分揭示。本研究旨在通过对复发性前肩脱位患者采用 1.3mm 全缝线锚钉进行关节镜下盂唇修复,探讨根据盂唇内植入锚钉的位置,盂唇下囊肿的连续变化。
我们纳入了 43 例因复发性前肩脱位伴或不伴有上盂唇从前到后撕裂和后盂唇撕裂而接受关节镜下盂唇修复的患者,所有患者均使用 1.3mm 全缝线锚钉。所有患者均在术后即刻行 CT 检查,术后 1 年或 2 年行 CT 关节造影(CTA)。盂唇下囊肿的平均直径和组织密度(HU)根据盂唇的位置进行测量。术后 2 年评估临床结果、盂唇愈合和再脱位率。
在功能评估方面,术后美国肩肘外科协会评分和 Rowe 评分均有统计学显著改善(术前分别为 47.9 ± 14.3、45.3 ± 12.4,术后分别为 90.1 ± 9.6、92.2 ± 10.1;均 < 0.01)。术后发现 2 例(4.7%)再脱位。在影像学评估中,术后 1 年盂唇下囊肿的平均直径(3.24 ± 0.65mm)明显大于术后即刻直径,但与术后 2 年相比无显著差异(3.23 ± 0.57mm)。囊肿中央的组织密度在术后 1 年和 2 年无显著差异(107.7 ± 29.8HU[上]、99.7 ± 31.7HU[前下]和 105.1 ± 25.0HU[后]vs. 109.1 ± 26.1HU[上]、106.4 ± 30.3HU[前下]和 111.0 ± 32.9HU[后])。与上或后位相比,前下位的盂唇下囊肿直径最大。
关节镜下盂唇修复后 1 年内,全缝线锚钉周围的盂唇下囊肿显著增大,与盂唇内植入锚钉的位置无关。然而,术后 1 年和 2 年盂唇下囊肿的大小和组织密度相似,获得了满意的稳定性和临床结果。