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使用单前入路的关节镜下Bankart修复术手术时间较短,临床结果与标准双入路技术相当。

Arthroscopic Bankart Repair Using 1 Anterior Portal Has a Shorter Surgical Time and Comparable Clinical Results With the Standard 2-Portal Technique.

作者信息

Gazeloglu Ali Okan, Yilmaz Abdurrahman, Turhan Egemen, Familiari Filippo, Huri Gazi

机构信息

Sincan Training and Research Hospital, Ankara, Turkey.

Department of Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey.

出版信息

Arthrosc Sports Med Rehabil. 2024 Jul 26;6(6):100984. doi: 10.1016/j.asmr.2024.100984. eCollection 2024 Dec.

Abstract

PURPOSE

To assess the modified 1 anterior portal Bankart repair and compare it to the 2-portal Bankart repair in terms of surgical time, functional scores, and recurrent dislocation.

METHODS

Patients who underwent Bankart repair from 2014 to 2021 were identified and separated into 2 groups: a modified 1 anterior portal group and a 2 anterior portal group. The inclusion criteria were being >18 years old, having a recurrent anterior shoulder dislocation with a Bankart lesion, and having a minimum 2-year follow-up. Patients were evaluated for their clinical results using the American Shoulder and Elbow Surgeons score, the Western Ontario Shoulder Instability index, and the Oxford Shoulder Instability Score pre- and postoperatively. The duration of surgery and recurrent instability were recorded. To prevent suture tangling in the modified 1-portal group, 2 techniques were performed: "cannula in cannula" and "cannula in and out."

RESULTS

A total of 42 patients were included in this study, with 20 in the modified 1-portal group and 22 in the 2-portal group. There were no statistically significant differences between the 2 groups in clinical scores obtained after 2 years of surgery (American Shoulder and Elbow Surgeons score,  = .5; Western Ontario Shoulder Instability index,  = .22; and Oxford Shoulder Instability Score,  = .32). The average surgical duration in the modified 1-portal group (65.7 ± 15.8) was significantly shorter than the average surgery duration in the 2-portal group (81.1 ± 27.2) ( = .03). There was no statistically significant difference between the 2 groups for recurrent instability ( ≥ .999).

CONCLUSIONS

Bankart repair performed through a modified 1 anterior portal technique has a shorter surgical time and similar clinical outcomes as the 2-portal technique.

LEVEL OF EVIDENCE

Level III, retrospective cohort study.

摘要

目的

评估改良单前入路Bankart修复术,并在手术时间、功能评分和复发性脱位方面将其与双入路Bankart修复术进行比较。

方法

确定2014年至2021年接受Bankart修复术的患者,并将其分为两组:改良单前入路组和双前入路组。纳入标准为年龄大于18岁、复发性肩关节前脱位伴Bankart损伤且随访至少2年。术前和术后使用美国肩肘外科医生评分、西安大略肩关节不稳定指数和牛津肩关节不稳定评分对患者的临床结果进行评估。记录手术时间和复发性不稳定情况。为防止改良单入路组缝线缠绕,采用了两种技术:“套管内套管”和“套管进出”。

结果

本研究共纳入42例患者,改良单入路组20例,双入路组22例。两组术后2年获得的临床评分无统计学显著差异(美国肩肘外科医生评分,P = 0.5;西安大略肩关节不稳定指数,P = 0.22;牛津肩关节不稳定评分,P = 0.32)。改良单入路组的平均手术时间(65.7±15.8)明显短于双入路组的平均手术时间(81.1±27.2)(P = 0.03)。两组在复发性不稳定方面无统计学显著差异(P≥0.999)。

结论

通过改良单前入路技术进行的Bankart修复术与双入路技术相比,手术时间更短,临床结果相似。

证据水平

三级,回顾性队列研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eafa/11701983/819f9c01ca8b/gr1.jpg

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