Hong Ian S, Sonnenfeld Julian J, Sicat Chelsea Sue, Hong Robin S, Trofa David P, Schiffern Shadley C, Hamid Nady, Fleischli James E, Saltzman Bryan M
OrthoCarolina Sports Medicine Center, Charlotte, North Carolina, U.S.A.; Musculoskeletal Institute, Atrium Health, Charlotte, North Carolina, U.S.A.
OrthoCarolina Sports Medicine Center, Charlotte, North Carolina, U.S.A.
Arthroscopy. 2023 Feb;39(2):438-451. doi: 10.1016/j.arthro.2022.03.030. Epub 2022 Apr 7.
To provide an update of recent literature with a specialized focus on clinical outcomes following arthroscopic revision Bankart repair (ARBR) by performing a systematic review of all available literature published between 2013 and 2020.
A literature search reporting clinical outcomes after ARBR was performed. Criteria for inclusion consisted of original studies; Level of Evidence of I-IV; studies focusing on clinical outcomes after ARBR published between January 1, 2013, and January 4, 2021; studies reporting recurrent dislocation or instability rate after ARBR; reoperation/revision following ARBR, return to sport rates following ARBR; and patient-reported outcomes. The primary outcomes of interest were failure defined as recurrent instability or dislocation, return to sport rates, and patient-reported outcomes at follow-up.
A large proportion of patients undergoing arthroscopic revision Bankart repair were male, ranging between 67.7% and 93.8%. Failure rate and return to sports rate ranged between 6.1% and 46.8% and 25.9% and 88.3%, respectively, when patients with significant or greater than 20% glenoid bone loss was excluded. Patient-reported outcome scores, which included American Shoulder and Elbow Surgeons, Simple Shoulder Test, and visual analog scale, saw significant improvement over mean follow-up of ranging 21.64 to 60 months.
Both the failure rate and RTS rates after ARBR had a wide range, given the heterogeneity of the studies included, which varied in patient selection criteria pertaining to patients with greater than 20% glenoid bone. Although there have been advancements in arthroscopic techniques and a trend favoring arthroscopic stabilization procedures, there is a lack of consensus in recent literature for careful patient selection criteria that would minimize failure rates and maximize RTS rates after ARBR.
Level IV, a systematic review of Level III-IV studies.
通过对2013年至2020年间发表的所有可用文献进行系统评价，提供近期文献的最新情况，特别关注关节镜下改良Bankart修复术（ARBR）后的临床结果。
进行了一项关于ARBR后临床结果的文献检索。纳入标准包括原始研究；证据等级为I-IV级；2013年1月1日至2021年1月4日期间发表的关注ARBR后临床结果的研究；报告ARBR后复发性脱位或不稳定率的研究；ARBR后的再次手术/翻修、ARBR后的恢复运动率；以及患者报告的结果。感兴趣的主要结果是定义为复发性不稳定或脱位的失败、恢复运动率以及随访时患者报告的结果。
接受关节镜下改良Bankart修复术的患者中很大一部分是男性，比例在67.7%至93.8%之间。当排除关节盂骨丢失显著或大于20%的患者时，失败率和恢复运动率分别在6.1%至46.8%和25.9%至88.3%之间。患者报告的结果评分，包括美国肩肘外科医师协会评分、简单肩部测试和视觉模拟量表，在平均21.64至60个月的随访中显著改善。
鉴于纳入研究的异质性，ARBR后的失败率和恢复运动率范围都很广，这些研究在与关节盂骨大于20%的患者相关的患者选择标准方面存在差异。尽管关节镜技术有了进步，且有倾向于关节镜稳定手术的趋势，但近期文献中对于谨慎的患者选择标准缺乏共识，而这些标准可以将ARBR后的失败率降至最低并使恢复运动率最大化。
IV级，对III-IV级研究的系统评价。
