Gupta Tej P, Rai Sanjay, Kale Amit
Department of Orthopaedics, Base Hospital, Guwahati, IND.
Cureus. 2022 Aug 3;14(8):e27655. doi: 10.7759/cureus.27655. eCollection 2022 Aug.
Background Anterior traumatic shoulder dislocation is very common among soldiers or any young population following injury, which is invariably treated by closed reduction. The dislocation when treated nonsurgically has a 71% high rate of recurrence. There is not much data available on the rate of recurrence when primary dislocation (first time) was treated by arthroscopic Bankart repair and in those who have recurrent (multiple) dislocations before surgery. Aim This study aims to report the postoperative recurrence rate in soldiers with first-time dislocation versus those with recurrent dislocations before surgery. Study design The present study is a level IV case series treatment study. Methods In this prospective study, 143 soldiers were included, of which 82 patients had first-time dislocation (F group) and 61 patients had recurrent dislocation before surgery (R group). The patients were evaluated and followed up for over three years. Nonabsorbable PEEK suture anchors (Chetan Meditech, India) were used for arthroscopic Bankart repair. The recurrence rates, Rowe scores, visual analog scale (VAS) scores, subjective shoulder values (SSVs), and satisfaction were compared. We also used the Simple Shoulder Test (SST) score for evaluation. The scores were recorded preoperatively and at three-year follow-up. The range of motion, postoperative function, recurrence rates, and return to pre-injury state was evaluated. Results A total of 143 patients were included, providing 97.3% follow-up at an average of 36 months. The postoperative recurrence rate was 19.7% in the F group and 58.3% in the R group (P < 0.001). The odds of postoperative recurrence were five times higher in the recurrent dislocation group (odds ratio (OR): 5.23). Conclusion Patients who underwent repair after first-time dislocation show a lower postoperative recurrence rate as compared with those who had multiple dislocations before surgery. It is prudent to advise early repair even after the first dislocation especially in young active soldiers to reduce the risk of postoperative recurrence.
创伤性前肩关节脱位在士兵或任何年轻人群受伤后非常常见，通常采用闭合复位治疗。非手术治疗脱位的复发率高达71%。关于初次脱位（首次）采用关节镜下Bankart修复以及术前有复发性（多次）脱位患者的复发率，可用数据不多。
本研究旨在报告初次脱位士兵与术前有复发性脱位士兵的术后复发率。
本研究为IV级病例系列治疗研究。
在这项前瞻性研究中，纳入了143名士兵，其中82例为初次脱位患者（F组），61例为术前有复发性脱位患者（R组）。对患者进行了三年多的评估和随访。采用不可吸收聚醚醚酮缝合锚钉（印度Chetan Meditech公司）进行关节镜下Bankart修复。比较了复发率、Rowe评分、视觉模拟量表（VAS）评分、主观肩关节评分（SSV）和满意度。我们还使用简单肩关节测试（SST）评分进行评估。术前和三年随访时记录评分。评估了活动范围、术后功能、复发率和恢复到伤前状态的情况。
共纳入143例患者，平均随访36个月，随访率为97.3%。F组术后复发率为19.7%，R组为58.3%（P<0.001）。复发性脱位组术后复发的几率高出五倍（优势比（OR）：5.23）。
与术前有多次脱位的患者相比，初次脱位后接受修复的患者术后复发率较低。即使在初次脱位后，尤其是年轻活跃的士兵，建议早期修复以降低术后复发风险是明智的。
