Zhang Chunsen, Yang Songyun, Wang Jiapeng, Shao Wenze, Huang Yizhou, Tang Xin
Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, China.
BMC Sports Sci Med Rehabil. 2024 Jun 24;16(1):140. doi: 10.1186/s13102-024-00925-2.
Extensive research has been conducted to investigate the short-term and long-term outcomes of arthroscopic Bankart repair, yielding varying results across different populations. However, there remains a dearth of studies specifically focused on evaluating outcomes in recreational athletes.
A retrospective case series study was conducted on recreational athletes who underwent isolated arthroscopic Bankart repair between 2013 and 2021. The primary outcome assessed was recurrent instability, defined as dislocation or subluxation. Secondary outcomes included patient satisfaction, rates of returning to the same sports (RTS) and RTS at preinjury level, and patient-reported outcomes. Evaluation of the Rowe score, Constant score, American Shoulder and Elbow Surgeons score, and VAS pain score were performed. Prognostic factors for recurrent instability, including demographic and clinical characteristics, as well as postoperative magnetic resonance imaging (MRI) appearance of the labrum were analyzed.
A total of 191 patients met the selection criteria, with 150 (78.5%) available for the final follow-up. Recurrent instability occurred in 10.7% of patients, with a mean follow-up duration of 4.1 years. Younger age at surgery and more critical glenoid bone loss were significantly associated with recurrent instability (p = .038 and p = .011, respectively). The satisfaction rate regarding surgery was 90.0%. Rates of return to the same sports (RTS) and RTS at preinjury level were 82.0% and 49.3%, respectively. Clinical outcomes measured at the final follow-up were as follows: Rowe score - 92.8; Constant score - 98.0; ASES score - 98.3; VAS pain score - 0.2. Patients with recurrent instability had significantly inferior outcomes in terms of satisfaction rate, RTS at preinjury level rate, Rowe score, and Constant score (p = .000, p = .039, p = .000, and p = .015, respectively). A total of thirty-seven patients underwent MRI examination six months after surgery in our institution. The T2-weighted anterior labrum morphology was found to be poorer in patients with recurrent instability. No significant difference was observed between patients with or without recurrent instability in terms of anterior Slope, anterior labral glenoid height index (LGHI), inferior Slope, inferior LGHI, and T2-weighted inferior labrum morphology.
Arthroscopic Bankart repair can yield satisfactory medium-term outcomes for recreational athletes. Younger age at surgery, more critical glenoid bone loss, and poorer T2-weighted anterior labrum morphology assessed six months postoperatively were significantly associated with recurrent instability.
已经开展了广泛的研究来调查关节镜下Bankart修复术的短期和长期疗效，不同人群的结果各异。然而，专门针对评估业余运动员疗效的研究仍然匮乏。
对2013年至2021年间接受单纯关节镜下Bankart修复术的业余运动员进行了一项回顾性病例系列研究。评估的主要结局是复发性不稳定，定义为脱位或半脱位。次要结局包括患者满意度、恢复到相同运动项目（RTS）的比例以及恢复到伤前水平的RTS比例，以及患者报告的结局。进行了Rowe评分、Constant评分、美国肩肘外科医师协会（ASES）评分和视觉模拟评分法（VAS）疼痛评分的评估。分析了复发性不稳定的预后因素，包括人口统计学和临床特征，以及术后盂唇的磁共振成像（MRI）表现。
共有191例患者符合入选标准，其中150例（78.5%）可进行最终随访。10.7%的患者出现复发性不稳定，平均随访时间为4.1年。手术时年龄较小和肩胛盂骨丢失更严重与复发性不稳定显著相关（分别为p = 0.038和p = 0.011）。手术满意度为90.0%。恢复到相同运动项目（RTS）的比例和恢复到伤前水平的RTS比例分别为82.0%和49.3%。最终随访时测量的临床结局如下：Rowe评分 - 92.8；Constant评分 - 98.0；ASES评分 - 98.3；VAS疼痛评分 - 0.2。复发性不稳定的患者在满意度、恢复到伤前水平的RTS比例、Rowe评分和Constant评分方面的结局明显较差（分别为p = 0.000、p = 0.039、p = 0.000和p = 0.015）。在我们机构，共有37例患者在术后6个月接受了MRI检查。发现复发性不稳定的患者T2加权像上的前盂唇形态较差。在有或没有复发性不稳定的患者之间，在前斜率、前盂唇肩胛盂高度指数（LGHI）、下斜率、下LGHI和T2加权像上的下盂唇形态方面未观察到显著差异。
关节镜下Bankart修复术可为业余运动员带来令人满意的中期疗效。手术时年龄较小、肩胛盂骨丢失更严重以及术后6个月评估的T2加权像上前盂唇形态较差与复发性不稳定显著相关。
