Department of Orthopedics, Kurume University Hospital.
Department of Orthopedics, Kurume University Medical Center.
Kurume Med J. 2021 Dec 15;66(4):203-207. doi: 10.2739/kurumemedj.MS664006. Epub 2021 Oct 25.
Current advances in arthroscopic surgery have led to good outcomes for arthroscopic Bankart repair (ABR) for recurrent anterior shoulder dislocation. However, recent studies have reported recurrence rates of 4%-19% after ABR. In our survey conducted from February 2002 to December 2010, the post-ABR re-dislocation rate was 8.8%. In 2011, we began performing the ABR with open Bristow (B) procedure or Remplissage (R) procedure in patients with large glenoid or humeral head bone defects and in patients who play collision sports. Therefore, the present study is the second series evaluating the incidence of re-dislocation and instability after recurrent anterior shoulder dislocation.
Surgery was performed for 84 cases of shoulder instability from January 2011 to August 2017. After excluding 7 open surgeries, 6 reoperations, and 2 patients with multidirectional instability, telephone interviews were conducted with 69 patients. The average follow-up duration was 46.9 months (range, 13-92 months).
ABR alone was performed 61 patients; the B procedure was added for 3 patients, and the R procedure was added for 5 patients. Telephone interviews were conducted with 61 patients. There were no cases of re-dislocation or reoperation. Four patients who underwent only ABR experienced postoperative instability, but not to the extent that their daily lives were affected.
This study showed that the addition of R or B technique to ABR for recurrent anterior shoulder dislocation resulted in a 0% re-dislocation rate.
关节镜技术的进步使关节镜下 Bankart 修复术(ABR)治疗复发性肩关节前脱位取得了良好的效果。然而,最近的研究报告显示,ABR 后复发率为 4%-19%。在我们 2002 年 2 月至 2010 年 12 月进行的调查中,ABR 后的再脱位率为 8.8%。2011 年,我们开始在有较大肩盂或肱骨头骨缺损的患者以及从事碰撞运动的患者中采用开放 Bristow(B)手术或 Remplissage(R)手术进行 ABR。因此,本研究是评估复发性肩关节前脱位后再脱位和不稳定发生率的第二个系列。
我们对 2011 年 1 月至 2017 年 8 月期间因肩关节不稳定而接受手术的 84 例患者进行了研究。排除 7 例开放性手术、6 例再次手术和 2 例多向不稳定患者后,对 69 例患者进行了电话访谈。平均随访时间为 46.9 个月(范围:13-92 个月)。
单独进行 ABR 的有 61 例患者;其中 3 例加行了 B 手术,5 例加行了 R 手术。对 61 例患者进行了电话访谈。没有再脱位或再次手术的病例。仅行 ABR 的 4 例患者术后出现不稳定,但未影响日常生活。
本研究表明,将 R 或 B 技术应用于复发性肩关节前脱位的 ABR 可使再脱位率降至 0%。