Okamura Kenji, Yamamoto Nobuyuki
Department of Orthopaedic Surgery, Hitsujigaoka Hospital, Sapporo, Japan.
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
JSES Int. 2024 Feb 2;8(3):429-433. doi: 10.1016/j.jseint.2024.01.004. eCollection 2024 May.
Recurrence rates after first-time shoulder dislocation in young patients are high, especially in their early teens. Only a few studies have arthroscopically investigated the inside of the glenohumeral joint in young patients. Such arthroscopic investigation would help in solving the cause of the greater incidence of recurrent instability in the young population, especially in their early teens.
Data from 42 patients with first-time anterior shoulder dislocation were retrospectively reviewed. The participants were divided into two groups: those aged 10 to 15 years at the time of the dislocation (adolescent group) and those aged 20- 29 years (adult group). The arthroscopic findings regarding the glenohumeral joint in the adolescent group were assessed and compared to those in the adult group. The intra-articular pathology was examined in all cases and recorded with specific reference to (1) the anterior capsulolabral lesion, (2) Hill-Sachs lesion, (3) labrum-anteroinferior glenohumeral ligament complex, and (4) other concomitant lesions.
Anterior joint laxity was found more in the adolescent group than in the adult group ( = .046). Thirty-six (83%) shoulders had Hill-Sachs lesions: 6 shoulders (60%) in the adolescent group and 30 shoulders (97%) in the adult group, with a significant difference ( < .001).
Pathological findings observed during arthroscopy are more common in the adult group, whereas recurrent instability is more likely in adolescent group.
年轻患者首次肩关节脱位后的复发率很高,尤其是在他们十几岁的早期阶段。只有少数研究通过关节镜检查了年轻患者的盂肱关节内部情况。这种关节镜检查将有助于找出年轻人群中,尤其是十几岁早期阶段的人群复发性不稳定发生率较高的原因。
回顾性分析42例首次肩关节前脱位患者的数据。参与者被分为两组:脱位时年龄在10至15岁的患者(青少年组)和年龄在20至29岁的患者(成人组)。评估青少年组盂肱关节的关节镜检查结果,并与成人组进行比较。检查所有病例的关节内病变,并特别记录以下方面:(1)前关节囊盂唇损伤;(2)希尔-萨克斯损伤;(3)盂唇-盂肱前下韧带复合体;(4)其他伴随损伤。
青少年组的前关节松弛比成人组更常见(P = 0.046)。36例(83%)肩关节有希尔-萨克斯损伤:青少年组6例(60%),成人组30例(97%),差异有统计学意义(P < 0.001)。
关节镜检查时观察到的病理结果在成人组中更常见,而青少年组更易出现复发性不稳定。