Pathak Shirish, Haidermota Murtaza J, H Vimal Kumar K, Sancheti Parag
Department of Shoulder and Sports Medicine, Deenanath Mangeshkar Hospital and Research Centre, Maharashtra, India.
Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Shivajinagar, Maharashtra, India.
Arthrosc Sports Med Rehabil. 2022 Feb 1;4(2):e695-e703. doi: 10.1016/j.asmr.2021.12.014. eCollection 2022 Apr.
To demonstrate whether arthroscopic remplissage can achieve good outcomes without significantly impairing shoulder function.
Consecutive patients with recurrent anterior glenohumeral dislocation, glenoid bone loss <20%, and engaging Hill-Sachs lesion who were operated with arthroscopic Bankart repair and remplissage between 2013 and 2016 were identified. Patients were evaluated clinically for shoulder instability, range of motion, and scored as per Oxford Shoulder Instability Score and University of California at Los Angeles score. The data were analyzed with the paired test and the Wilcoxon signed rank test, as applicable. For all analyses, statistical significance was set at < .05.
Twenty-four patients were included in the study. The average age of the patients was 30 years (range, 18-47 years), with 91.67% (n = 22) male patients and 8.33% (n = 2) female patients. The range of motion at follow-up was comparable with the normal side, with loss of external rotation of 3.33° (n = 24). Significant improvement was observed in the Oxford Shoulder Instability Score (21.95 vs 41.29, < 0.001) and University of California at Los Angeles score (18.33 vs 30.29, < .001). A failure rate of 4.17% (1 patient with a positive apprehension test) was seen.
Arthroscopic Bankart repair with the remplissage procedure helps to re-establish stability and achieve good shoulder outcomes for patients with recurrent anterior glenohumeral dislocation and an engaging Hill-Sachs lesion and without significant glenoid bone loss.
Level IV, therapeutic.
证明关节镜下充填术能否在不显著损害肩关节功能的情况下取得良好疗效。
确定2013年至2016年间接受关节镜下Bankart修复术和充填术的复发性前盂肱关节脱位、关节盂骨缺损<20%且存在嵌顿性Hill-Sachs损伤的连续患者。对患者进行肩关节不稳定、活动范围的临床评估，并根据牛津肩关节不稳定评分和加利福尼亚大学洛杉矶分校评分进行评分。数据采用配对t检验和Wilcoxon符号秩检验进行分析（如适用）。所有分析中，统计学显著性设定为P<0.05。
24例患者纳入研究。患者平均年龄30岁（范围18 - 47岁），男性患者占91.67%（n = 22），女性患者占8.33%（n = 2）。随访时的活动范围与正常侧相当，外旋丧失3.33°（n = 24）。牛津肩关节不稳定评分（21.95对41.29，P<0.001）和加利福尼亚大学洛杉矶分校评分（18.33对30.29，P<0.001）有显著改善。失败率为4.17%（1例恐惧试验阳性患者）。
关节镜下Bankart修复术联合充填术有助于为复发性前盂肱关节脱位、存在嵌顿性Hill-Sachs损伤且无明显关节盂骨缺损的患者重建稳定性并取得良好的肩关节疗效。
四级，治疗性。
