Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.
Beijing Key Laboratory of Sports Injuries, Beijing, China.
Orthop Surg. 2024 May;16(5):1073-1078. doi: 10.1111/os.14032. Epub 2024 Mar 15.
Bankart lesion is one of the most common lesions of the glenohumeral joint. Several double-row suture methods were reported for Bankart repair, which could provide more stability, yet more motion limitation and complications. Therefore, we introduced a new double-row Bankart repair technique, key point double-row suture which used one anchor in the medial line. The purpose of this article is to investigate the clinical outcomes of this new method and to compare it with single-row suture.
Seventy-eight patients receiving key point double-row suture or single-row suture from October 2010 to June 2014 were collected retrospectively. The basic information including gender, age, dominant arm, and number of episodes of instability was collected. Before surgery, the glenoid bone loss was measured from the CT scan. The visual analogue scale, American shoulder and elbow surgeons, the University of California at Los Angeles shoulder scale, and subjective shoulder value were valued before surgery and at the last follow-up.
Forty-four patients (24 patients receiving single-row suture and 20 patients receiving key point double-row suture) were followed up successfully. The follow-up period was 9.2 ± 1.1 years (range, 7.8-11.4 years). At the last follow-up, no significant differences were detected for any of the clinical scores. The recurrence rate was 12.5% for the single-row group and 10% for the double-row group, respectively (p = 0.795) 14 patients (31.8%) in the single-row group and nine patients (26.5%) in the double-row group were tested for active range of motion. A statistically significant difference was found only for the internal rotation at 90° abduction (48.9° for single-row and 76.7° for key point double-row, p = 0.033).
The key point double-row sutures for Bankart lesions could achieve similar long-term outcomes compared with single-row suture, and one medial anchor did not result in a limited range of motion. The low recurrence rate and previous biomechanical results also indicate the key point double-row suture is a reliable method.
Bankart 损伤是肩关节最常见的损伤之一。有几种双排缝线方法被报道用于 Bankart 修复,可以提供更稳定的效果,但运动受限和并发症更多。因此,我们引入了一种新的双排 Bankart 修复技术,关键点双排缝线,即在中线上使用一个锚钉。本文的目的是研究这种新方法的临床结果,并将其与单排缝线进行比较。
回顾性收集 2010 年 10 月至 2014 年 6 月接受关键点双排缝线或单排缝线的 78 例患者。收集患者的基本信息,包括性别、年龄、优势臂和不稳定发作次数。术前通过 CT 扫描测量肩盂骨缺损。术前和末次随访时采用视觉模拟评分(VAS)、美国肩肘外科医师协会(ASES)评分、加利福尼亚大学洛杉矶分校(UCLA)评分和主观肩关节评分进行评估。
44 例患者(单排缝线组 24 例,关键点双排缝线组 20 例)获得随访,随访时间为 9.2±1.1 年(7.8-11.4 年)。末次随访时,两组患者的临床评分均无显著差异。单排缝线组的复发率为 12.5%,双排缝线组为 10%(p=0.795)。单排缝线组 14 例(31.8%)、双排缝线组 9 例(26.5%)患者接受主动活动范围测量。仅在肩外展 90°内旋时发现统计学差异(单排缝线组 48.9°,关键点双排缝线组 76.7°,p=0.033)。
关键点双排缝线治疗 Bankart 病变可获得与单排缝线相似的长期疗效,且使用一个中侧锚钉不会导致活动范围受限。较低的复发率和先前的生物力学结果也表明,关键点双排缝线是一种可靠的方法。