Scanaliato John P, Dunn John C, Fares Austin B, Czajkowski Hunter, Parnes Nata
William Beaumont Army Medical Center, El Paso, Texas, USA.
Carthage Area Hospital, Carthage, New York, USA.
Am J Sports Med. 2022 Feb;50(2):334-340. doi: 10.1177/03635465211061602. Epub 2021 Dec 13.
There is a high prevalence of combined shoulder instability in military patients. Short-term outcomes after 270° labral repair are promising; however, there is a paucity of longer term outcome data in this high-demand group of patients.
To report the midterm outcomes of active-duty military patients treated with 270° labral repair for combined shoulder instability.
Case series; Level of evidence, 4.
All consecutive patients between January 2011 and January 2019 who underwent 270° labral repair by the senior surgeon with complete outcome scores were identified. All patients had experienced a shoulder dislocation after a traumatic event and had magnetic resonance imaging and intraoperative findings consistent with combined-type instability. A total of 52 patients met the inclusion criteria for the study, and all were active-duty servicemembers at the time of surgery.
The mean follow-up was 78.21 months (range, 24-117 months). There was a statistically significant increase in the mean American Shoulder and Elbow Surgeons score (from 44.92 to 89.31; < .0001), Single Assessment Numeric Evaluation score (from 52.32 to 93.17; < .0001), and Rowe instability score (from 46.63 to 91.35; < .0001) from preoperatively to postoperatively. Mean pain decreased significantly as measured by the visual analog scale for pain (from 8.04 to 1.44; < .0001). Range of motion in forward flexion (from 155.29° to 155.96°; = .6793), external rotation (from 67.50° to 65.29°; = .0623), and internal rotation (from T9.58 to T9.56; = .9650) did not change significantly postoperatively. Outcomes did not differ significantly for patients who underwent surgery on their dominant shoulder versus those who underwent surgery on their nondominant shoulder, nor did outcomes vary with the type of anchor utilized (biocomposite vs all-suture). The overall rate of return to active duty was 92.31%.
Midterm outcomes in this population of active-duty patients undergoing 270° labral repair for combined shoulder instability demonstrated a statistically and clinically significant improvement in patient-reported outcome scores, a significant decrease in pain, and an overall rate of return to active duty of 92.31%.
军事患者中合并性肩关节不稳的患病率很高。270°盂唇修复术后的短期疗效很有前景；然而，在这群高需求患者中，长期疗效数据却很匮乏。
报告接受270°盂唇修复术治疗合并性肩关节不稳的现役军事患者的中期疗效。
病例系列；证据等级，4级。
确定了2011年1月至2019年1月期间由资深外科医生进行270°盂唇修复且有完整疗效评分的所有连续患者。所有患者在创伤事件后均经历过肩关节脱位，且磁共振成像和术中检查结果与复合型不稳相符。共有52例患者符合该研究的纳入标准，且所有患者在手术时均为现役军人。
平均随访时间为78.21个月（范围为24 - 117个月）。从术前到术后，美国肩肘外科医生评分（从44.92提高到89.31；P <.0001）、单项评估数值评定评分（从52.32提高到93.17；P <.0001）和Rowe不稳评分（从46.63提高到91.35；P <.0001）均有统计学意义的显著提高。根据视觉模拟疼痛量表测量，平均疼痛显著降低（从8.04降至1.44；P <.0001）。术后前屈活动度（从155.29°到155.96°；P =.6793）、外旋活动度（从67.50°到65.29°；P =.0623）和内旋活动度（从T9.58到T9.56；P =.9650）没有显著变化。优势肩手术患者与非优势肩手术患者的疗效没有显著差异，使用的锚钉类型（生物复合材料与全缝线）对疗效也没有影响。总体重返现役率为92.31%。
这群接受270°盂唇修复术治疗合并性肩关节不稳的现役患者的中期疗效显示，患者报告的疗效评分在统计学和临床上都有显著改善，疼痛显著减轻，总体重返现役率为92.31%。
