Vieider Romed P, Siebenlist Sebastian, Sanchez Jose C, Heil Selina, Wackerle Anja, Fritsch Lorenz, Scheiderer Bastian, Hinz Maximilian, Lacheta Lucca
Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.
J Clin Med. 2024 Aug 27;13(17):5067. doi: 10.3390/jcm13175067.
This study aimed to compare clinical outcomes and recurrence of instability after arthroscopic Bankart repair (ABR) in patients with anterior shoulder instability, with and without a GLAD lesion, while distinguishing between primary and recurrent instability. Consecutive patients who underwent isolated ABR between January 2012 and December 2021 were included. Patients with a concomitant GLAD lesion were matched in with patients without a GLAD lesion according to the following criteria: age, sex, BMI, follow-up time, and primary versus recurrent instability. At minimum two-year follow-up, the clinical outcome (Rowe score, redislocation rate) and the functional outcome, including the American Shoulder and Elbow Surgeons (ASES) score, Western Ontario Shoulder Instability Index (WOSI), Oxford Shoulder Instability Score (OSIS), satisfaction (1-10 scale, 0 = unsatisfied, 10 = very satisfied), and Visual Analogue Scale (VAS), were compared between groups. In total, 28 patients (14 GLAD vs. 14 Bankart; age: 32.5 ± 13.0 years; sex: 92.9% male; BMI: 24.6 ± 2.2) were included 6.9 ± 2.8 (2-11) years after isolated ABR (follow-up rate 63.6%). Clinical and functional outcome did not differ significantly between patients with versus without GLAD lesions (ASES score: 100 [96.5-100] vs. 97.5 [93.3-100], = 0.27); WOSI (%): 9.0 [3.7-24.5] vs. 3.8 [0.8-8.9], = 0.22; Rowe score: 90.0 [75.0-100] vs. 95.0 [78.8-100], = 0.57; OSIS: 46 [44.7-48] vs. 46 [43.0-48], = 0.54; satisfaction: 8.9 ± 1.4 vs. 8.0 ± 1.4, 0.78; VAS 0 [0-1.3] vs. 0 [0-1.0]. In both groups, two patients (14.3%) reported a redislocation during the observation period. At short- to mid-term follow-up, ABR showed favorable outcomes, low dislocation rates, and high patient satisfaction, regardless of the presence of a GLAD lesion or primary versus recurrent instability. However, follow-up time was heterogeneous, and the follow-up rate was marginal.
本研究旨在比较关节镜下Bankart修复术(ABR)治疗前肩不稳患者(伴或不伴GLAD损伤)的临床结局和不稳定复发情况,同时区分初次和复发性不稳定。纳入2012年1月至2021年12月期间接受单纯ABR的连续患者。伴有GLAD损伤的患者与无GLAD损伤的患者根据以下标准进行匹配:年龄、性别、体重指数、随访时间以及初次与复发性不稳定。在至少两年的随访中,比较两组的临床结局(Rowe评分、再脱位率)和功能结局,包括美国肩肘外科医师(ASES)评分、西安大略肩不稳定指数(WOSI)、牛津肩不稳定评分(OSIS)、满意度(1 - 10分,0 = 不满意,10 = 非常满意)以及视觉模拟量表(VAS)。总共纳入了28例患者(14例GLAD损伤患者与14例Bankart损伤患者;年龄:32.5±13.0岁;性别:92.9%为男性;体重指数:24.6±2.2),在单纯ABR术后6.9±2.8(2 - 11)年(随访率63.6%)。有或无GLAD损伤的患者之间临床和功能结局无显著差异(ASES评分:100[96.5 - 100]对97.5[93.3 - 100],P = 0.27);WOSI(%):9.0[3.7 - 24.5]对3.8[0.8 - 8.9],P = 0.22;Rowe评分:90.0[75.0 - 100]对95.0[78.8 - 100],P = 0.57;OSIS:46[44.7 - 48]对46[43.0 - 48],P = 0.54;满意度:8.9±1.4对8.0±1.4,P = 0.78;VAS 0[0 - 1.3]对0[0 - 1.0]。两组均有2例患者(14.3%)在观察期内报告有再脱位。在短期至中期随访中,无论是否存在GLAD损伤或初次与复发性不稳定,ABR均显示出良好的结局、低脱位率和高患者满意度。然而,随访时间不一致,且随访率较低。