Nattfogel Emma Abrahams, Ranebo Mats C
Department of Orthopedics, Kalmar County Hospital, Kalmar, Sweden.
Department of Biomedical and Clinical Sciences (BKV), Division of Surgery, Orthopedics and Oncology (KOO), Medical Faculty, Linköping University, Linköping, Sweden.
Arthrosc Sports Med Rehabil. 2024 Jan 14;6(1):100864. doi: 10.1016/j.asmr.2023.100864. eCollection 2024 Feb.
To evaluate the redislocation rate after arthroscopic Bankart repair (ABR) with a standardized knotless anchor technique in a consecutive series of patients with anterior glenohumeral instability.
Inclusion criteria were patients who underwent ABR by a single surgeon between January 2008 and December 2018 with a minimum follow up of 2 years. We collected data through phone interviews, Western Ontario Shoulder Instability Index, and review of patient records. The primary outcome was redislocation and secondary outcomes were recurrent subluxations, reoperation, postoperative complications, patient satisfaction, and functional outcomes. We also performed survival analysis and risk factor analysis.
Of 88 patients (91 shoulders) who underwent ABR during the inclusion period, 70 patients (73 shoulders) were included (follow-up rate 80%). The mean follow-up was 7.5 years (range 2-12 years). Redislocation occurred in 15% (95% confidence interval [CI] 7.8%-25.4%) of patients at a mean of 41 months after surgery (range 6-115 months). The reoperation rate for recurrent redislocation was 4.1%. Overall, 90.4% reported being currently satisfied with their shoulder and the mean Western Ontario Shoulder Instability Index score at follow-up was 73.8% (range 8.3%-99.9%). Patients with redislocation were younger at primary operation than patients with no redislocation (mean 21 years vs 28 years; = .023) and adjusted hazard ratio for age was 0.86 (95% CI 0.74-0.99; = .033). It was more common to have less than 3 anchors in patients with redislocation ( = .024), but adjusted hazard ratio was 4.42 (95% CI 0.93-21.02; = .061).
The redislocation rate after ABR with a standardized knotless anchor technique in a consecutive series of patients with anterior glenohumeral instability was found to be 15% after a minimum 2-year follow-up (mean 7.5).
Level IV, therapeutic case-series.
在一系列连续性的肩肱关节前向不稳患者中，采用标准化无结锚钉技术评估关节镜下Bankart修复术（ABR）后的再脱位率。
纳入标准为2008年1月至2018年12月间由同一外科医生实施ABR且随访至少2年的患者。我们通过电话访谈、西安大略肩不稳指数以及查阅患者病历收集数据。主要结局是再脱位，次要结局包括复发性半脱位、再次手术、术后并发症、患者满意度及功能结局。我们还进行了生存分析和危险因素分析。
在纳入期接受ABR的88例患者（91个肩关节）中，70例患者（73个肩关节）被纳入研究（随访率80%）。平均随访时间为7.5年（范围2 - 12年）。15%（95%置信区间[CI] 7.8% - 25.4%）的患者出现再脱位，平均发生在术后41个月（范围6 - 115个月）。复发性再脱位的再次手术率为4.1%。总体而言，90.4%的患者表示目前对其肩部状况满意，随访时西安大略肩不稳指数的平均评分为73.8%（范围8.3% - 99.9%）。发生再脱位的患者初次手术时年龄比未发生再脱位的患者年轻（平均21岁对28岁；P = 0.023），年龄的调整风险比为0.86（95% CI 0.74 - 0.99；P = 0.033）。再脱位患者使用少于3枚锚钉的情况更常见（P = 0.024），但调整风险比为4.42（95% CI 0.93 - 21.02；P = 0.061）。
在一系列连续性的肩肱关节前向不稳患者中，采用标准化无结锚钉技术行ABR后，经过至少2年（平均7.5年）的随访，发现再脱位率为15%。
IV级，治疗性病例系列研究。
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