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关节镜下髂骨植骨悬吊固定是治疗关节松弛症伴不稳定骨性 Bankart 病的有效方法。

Suspension fixation of iliac bone grafts under arthroscopy is an effective method for the treatment of unstable bony Bankart disease of the shoulder joint in patients with joint relaxation.

机构信息

Department of Sports Medicine, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730050, Gansu, China.

Department of Hand Surgery, The Third People's Hospital of Jinan, Jinan, 250000, Shandong, China.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2023 May;31(5):1925-1931. doi: 10.1007/s00167-022-07127-8. Epub 2022 Aug 30.

Abstract

PURPOSE

To evaluate the results of arthroscopic autologous iliac bone graft suspension fixation combined with the Remplissage procedure in the treatment of recurrent shoulder dislocation with bony Bankart lesions and joint hyperlaxity.

METHODS

From 2018 to 2020, 22 patients with joint laxity underwent arthroscopic autologous iliac bone graft suspension fixation and Bankart repair combined with the Remplissage procedure due to recurrent shoulder dislocation. Clinical assessment included range of motion (forward flexion, abduction, 90° external rotation, conventional external rotation, adduction, and internal rotation), visual analog scale (VAS) score, Rowe score, University of California Los Angeles (UCLA) score, and Western Ontario Shoulder Instability Index (WOSI) score. Post-operatively, the healing of the bone graft was evaluated with computed tomography (CT) scanning.

RESULTS

All 22 patients were followed up for a mean of 19.3 ± 4.1 months. CT imaging showed that the healing time of the bone graft was 6-8 weeks. The patient satisfaction rate was 100%, there were no cases of redislocation, all patients returned to their preinjury training state, and the fear test was negative. At the final follow-up, the UCLA, VAS, Rowe, and WOSI scores were 29.8 ± 2.1, 2.2 ± 0.8, 89.4 ± 4.2, and 482.3 ± 46.2, respectively (p < 0.001).

CONCLUSION

Arthroscopic autologous iliac bone graft suspension fixation and Bankart repair combined with the Remplissage procedure are effective in preventing recurrent instability with joint hyperlaxity. Furthermore, no patient had redislocation.

LEVEL OF EVIDENCE

IV.

摘要

目的

评估关节镜下自体髂骨移植悬吊固定联合 Remplissage 术治疗伴有骨 Bankart 损伤和关节松弛的复发性肩关节前脱位的疗效。

方法

2018 年至 2020 年,22 例关节松弛患者因复发性肩关节前脱位接受关节镜下自体髂骨移植悬吊固定和 Bankart 修复联合 Remplissage 术。临床评估包括活动范围(前屈、外展、90°外旋、常规外旋、内收和内旋)、视觉模拟评分(VAS)、Rowe 评分、加州大学洛杉矶分校(UCLA)评分和西部安大略肩不稳定指数(WOSI)评分。术后通过计算机断层扫描(CT)评估植骨愈合情况。

结果

22 例患者均获得平均 19.3±4.1 个月随访。CT 影像学显示植骨愈合时间为 6-8 周。患者满意度为 100%,无再脱位病例,所有患者均恢复至术前训练状态,恐惧试验阴性。末次随访时,UCLA、VAS、Rowe 和 WOSI 评分分别为 29.8±2.1、2.2±0.8、89.4±4.2 和 482.3±46.2(p<0.001)。

结论

关节镜下自体髂骨移植悬吊固定联合 Bankart 修复联合 Remplissage 术治疗伴关节松弛的复发性肩关节前脱位效果确切,且无再脱位发生。

证据等级

IV 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8e9/10089981/2db7a6e088a6/167_2022_7127_Fig1_HTML.jpg

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