Hirose Takehito, Tanaka Makoto, Nakai Hidekazu
Department of Orthopaedic Surgery, Osaka International Medical & Science Center, Osaka, Japan.
Center for Sports Medicine, Osaka International Medical & Science Center, Osaka, Japan.
JSES Rev Rep Tech. 2024 Sep 16;5(1):46-52. doi: 10.1016/j.xrrt.2024.08.010. eCollection 2025 Feb.
Studies have revealed that anterior glenoid rim bone resorption occurs in the early stage after arthroscopic Bankart repair (ABR) if bony Bankart lesions are absent or fail to heal. However, this structural change has never been studied after repair by footprint fixation (FF). Additionally, the relationship between the extent of rim resorption and healing of the repaired capsulolabral complex (CLC) remains unclear. Therefore, this study aimed to investigate anterior glenoid rim changes after ABR by FF and to elucidate the correlation between rim resorption and the healing of the repaired CLC.
This was a retrospective study on shoulders that underwent ABR by a combination of knotless twin anchor FF and single row techniques for anterior shoulder instability from January 2022 to June 2023. From 44 shoulders, we included 23 after excluding 14 with preoperative bony Bankart lesions and 7 with missing postoperative imaging. We used 3-dimensional computed tomography scans to calculate the change in glenoid width (Δ%) due to anterior glenoid rim change from baseline to 3 months postoperatively and images from magnetic resonance arthrography, which was performed at around 5 months postoperatively, to evaluate CLC healing according to a 3-point grading scale (, 3 points; , 2 points; , 1 point) on 6 oblique axial slices perpendicular to the glenoid long axis. Finally, we calculated the correlation coefficient between Δ% and the healing index, that is, the mean CLC healing grade of the 6 slices.
Glenoid width decreased by 7.2% (range, 2.0%-12.8%; < .001). The mean CLC healing index was 2.59 points (range, 1.8-3.0). The Δ% showed a moderate positive correlation with the healing index (correlation coefficient, 0.55; = .006).
Anterior glenoid rim resorption also occurs after ABR by the combination of FF and single row technique at 3 months postoperatively. Although this is a preliminary result, the extent of rim resorption is greater with better healing of the repaired CLC.
研究表明，如果不存在骨性Bankart损伤或未能愈合，关节镜下Bankart修复术（ABR）后早期会出现肩胛盂前缘骨质吸收。然而，采用足迹固定（FF）修复后，这种结构变化从未被研究过。此外，边缘吸收程度与修复的关节囊盂唇复合体（CLC）愈合之间的关系仍不清楚。因此，本研究旨在调查FF修复ABR后肩胛盂前缘的变化，并阐明边缘吸收与修复的CLC愈合之间的相关性。
这是一项回顾性研究，研究对象为2022年1月至2023年6月因前肩不稳接受无结双锚FF和单排技术联合ABR的肩部。在44例肩部中，排除14例术前有骨性Bankart损伤和7例术后影像缺失的病例后，纳入23例。我们使用三维计算机断层扫描来计算术后3个月肩胛盂前缘变化导致的肩胛盂宽度变化（Δ%），并使用术后约5个月进行的磁共振关节造影图像，根据垂直于肩胛盂长轴的6个斜轴位片上的3分分级量表（，3分；，2分；，1分）评估CLC愈合情况。最后，我们计算了Δ%与愈合指数之间的相关系数，即6个切片的平均CLC愈合等级。
肩胛盂宽度减少了7.2%（范围为2.0%-12.8%；<0.001）。CLC平均愈合指数为2.59分（范围为1.8-3.0）。Δ%与愈合指数呈中度正相关（相关系数为0.55；=0.006）。
FF和单排技术联合ABR术后3个月也会出现肩胛盂前缘吸收。虽然这是一个初步结果，但修复的CLC愈合越好，边缘吸收程度越大。
