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无结全缝线、软锚定 Bankart 修复术在至少 2 年随访时具有极佳的患者报告结局、高患者满意度和可接受的复发性不稳定率。

Knotless All-Suture, Soft Anchor Bankart Repair Results in Excellent Patient-Reported Outcomes, High Patient Satisfaction, and Acceptable Recurrent Instability Rates at Minimum 2-Year Follow-Up.

机构信息

Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.

Steadman Philippon Research Institute, Vail, Colorado, U.S.A.

出版信息

Arthroscopy. 2023 Aug;39(8):1793-1799. doi: 10.1016/j.arthro.2023.02.021. Epub 2023 Mar 2.

Abstract

PURPOSE

To evaluate minimum 2-year outcomes after arthroscopic knotless all-suture soft anchor Bankart repair in patients with anterior shoulder instability.

METHODS

This was a retrospective case series of patients who underwent Bankart repair using soft, all-suture, knotless anchors (FiberTak anchors) from 10/2017 to 06/2019. Exclusion criteria were concomitant bony Bankart lesion, shoulder pathology other than that involving the superior labrum or long head biceps tendon, or previous shoulder surgery. Scores collected preoperatively and postoperatively included SF-12 PCS, ASES, SANE, QuickDASH, and patient satisfaction with various sports participation questions. Surgical failure was defined as revision instability surgery or redislocation requiring reduction.

RESULTS

A total of 31 active patients, 8 females and 23 males, with a mean age of 29 (range: 16-55) years were included. At a mean of 2.6 years (range: 2.0-4.0), patient-reported outcomes significantly improved over preoperative levels. ASES score improved from 69.9 to 93.3 (P < .001), SANE improved from 56.3 to 93.8 (P < .001), QuickDASH improved from 32.1 to 6.3 (P < .001) and SF-12 PCS improved from 45.6 to 55.7 (P < .001). Median patient postoperative satisfaction was 10/10 (range: 4-10). Patients reported a significant improvement sports participation (P < .001), pain with competition (P = .001), ability to compete in sports (P < .001), painless use of arm for overhead activities (P = .001), and shoulder function during recreational sporting activity (P < .001). Postoperative shoulder redislocations were reported in 4 cases (12.9%)-all after major trauma-with 2 patients progressing to Latarjet (6.45%) at 2 and 3 years postoperatively. There were no cases of postoperative instability without major trauma.

CONCLUSIONS

Knotless all-suture, soft anchor Bankart repair resulted in excellent patient-reported outcomes, high patient satisfaction, and acceptable recurrent instability rates, in this series of active patients. Redislocation after arthroscopic Bankart repair with a soft, all-suture anchor only occurred after return to competitive sports with new high-level trauma.

LEVEL OF EVIDENCE

Level IV, retrospective cohort study.

摘要

目的

评估关节镜下无结全缝线软锚定 Bankart 修复术治疗肩关节前不稳定患者的至少 2 年结果。

方法

这是一项回顾性病例系列研究,纳入了 2017 年 10 月至 2019 年 6 月期间接受 Bankart 修复术的患者,使用软、全缝线、无结软锚定(FiberTak 锚钉)。排除标准包括同时存在骨 Bankart 病变、除肩盂上唇或长头腱以外的肩部病变、或既往肩部手术。术前和术后收集的评分包括 SF-12 PCS、ASES、SANE、QuickDASH 和对各种运动参与问题的患者满意度。手术失败定义为翻修不稳定手术或需要复位的再脱位。

结果

共纳入 31 例活跃患者,8 名女性和 23 名男性,平均年龄 29 岁(范围:16-55 岁)。平均随访 2.6 年(范围:2.0-4.0 年),患者报告的结果较术前显著改善。ASES 评分从 69.9 提高到 93.3(P<.001),SANE 从 56.3 提高到 93.8(P<.001),QuickDASH 从 32.1 提高到 6.3(P<.001),SF-12 PCS 从 45.6 提高到 55.7(P<.001)。中位患者术后满意度为 10/10(范围:4-10)。患者报告运动参与度显著改善(P<.001)、比赛疼痛(P=.001)、运动比赛能力(P<.001)、无痛使用手臂进行过头活动(P=.001)和娱乐性运动活动时的肩部功能(P<.001)。4 例(12.9%)报告术后肩再脱位,均在重大创伤后发生,其中 2 例在术后 2 年和 3 年进展为 Latarjet(6.45%)。无术后无重大创伤的不稳定病例。

结论

在这一系列活跃患者中,无结全缝线软锚定 Bankart 修复术取得了优异的患者报告结果、高患者满意度和可接受的复发性不稳定率。关节镜 Bankart 修复术后的再脱位仅在重返竞争性运动后发生,伴有新的高水平创伤。

证据水平

IV 级,回顾性队列研究。

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