Lim Kia Teng, Tan Wei Ping Marcus, Tan Andrew Hwee Chye
Ministry of Health Holdings Pte Ltd, Singapore.
Current address: Department of Orthopaedic Surgery, National University Hospital, Singapore 119074, Singapore.
Shoulder Elbow. 2024 Nov 13:17585732241280247. doi: 10.1177/17585732241280247.
This study aims to evaluate long-term survivorship of arthroscopic Bankart repair (ABR).
About 101 patients under a single surgeon were followed up for ≥2 years post-ABR. Primary outcome was survivorship, defined as re-dislocation post-surgery. Secondary outcomes included a range of motion, strength, pain, University of California-Los-Angeles shoulder score, Oxford shoulder score (OSS), Oxford Shoulder Instability Score (OSIS), Constant Murley Score, and satisfaction. Clinical factors were correlated.
Eight patients experienced postoperative dislocation (5 high-energy trauma, 2 low-energy trauma, 1 atraumatic), with 2 patients requiring revision. The mean time to post-operative dislocation was 1.5 years (range 0.3-3.8). Competitive athletes demonstrated worse survivorship (p = 0.027) but greater isometric strength at 6 months (p = 0.041) compared to recreational players. Patients ≥25 years old experienced slower recovery of internal rotation at 3 months (p = 0.006). Patients with surgery >1 year after injury had slower recovery of external rotation (p = 0.006), worse Constant scores at 3 months (p = 0.036) and lesser improvements in isometric strength at 3 months (p = 0.032). Patients with single pre-operative dislocations (p = 0.036 OSS; p = 0.039 OSIS) and patients ≥25 years old (p = 0.044 OSS) had worse Oxford scores at 3 months.
ABR demonstrates good outcomes with low recurrence. This study prognosticates long-term outcomes across various subgroups.
本研究旨在评估关节镜下Bankart修复术（ABR）的长期生存率。
对同一位外科医生治疗的约101例患者进行ABR术后至少2年的随访。主要结局为生存率，定义为术后再脱位。次要结局包括活动范围、力量、疼痛、加州大学洛杉矶分校肩关节评分、牛津肩关节评分（OSS）、牛津肩关节不稳定评分（OSIS）、Constant Murley评分和满意度。对临床因素进行相关性分析。
8例患者发生术后脱位（5例高能量创伤，2例低能量创伤，1例无创伤），2例患者需要翻修。术后脱位的平均时间为1.5年（范围0.3 - 3.8年）。与业余运动员相比，竞技运动员的生存率较差（p = 0.027），但在6个月时等长力量更大（p = 0.041）。25岁及以上的患者在3个月时内旋恢复较慢（p = 0.006）。受伤后1年以上接受手术的患者外旋恢复较慢（p = 0.006），3个月时Constant评分较差（p = 0.036），3个月时等长力量改善较小（p = 0.032）。术前有单次脱位的患者（OSS，p = 0.036；OSIS，p = 0.039）和25岁及以上的患者（OSS，p = 0.044）在3个月时牛津评分较差。
ABR显示出良好的疗效且复发率低。本研究对各亚组的长期结局进行了预测。
