Öktem Umut, Özaltın Gülfem Ezgi, Yılmaz Sinan, Bozkurt İbrahim, Öçgüder Durmuş Ali
Department of Orthopedics and Traumatology, Bilkent City Hospital, Ankara, Türkiye.
Department of Physiotherapy and Rehabilitation, Inönü University, Malatya, Türkiye.
Acta Orthop Traumatol Turc. 2024 Dec 31;58(6):326-330. doi: 10.5152/j.aott.2024.23203.
This study aimed to investigate the e!ect of arthroscopic Bankart repair (ABR) alone and ABR with an additional remplissage procedure on joint range of motion and functional results in patients with anterior shoulder instability.
This retrospective study included patients treated 1 year ago with either ABR alone or the ABR additional remplissage procedure. The Bankart lesion was determined by magnetic resonance imaging, and the amount of glenoid bone loss was determined by computed tomography. Patients with glenoid bone loss <25% and on-track Hill-Sachs lesions (HSLs) were treated with ABR alone (22 females, 8 males; mean age=27.4 ± 6.4 years). Those with o!-track HSL were treated with both ABR and remplissage (20 females, 10 males; mean age=27.5 ± 5.3 years). One year after surgical treatment, the joint range of motion of the patients was determined by a universal goniometer, and functional status was evaluated using the Rowe score.
Sixty shoulders of 60 patients were evaluated over an average period of 1 year. There was no di!erence between groups regarding age (P=.767) and gender (P=.779). There were 42 female and 18 male patients, with a mean age=27.5 ± 5.8 years. There was a significant di!erence between the groups in patients' external rotation with arm adduction (ER1) (P=.001), external rotation with arm abduction (ER2) (P=.001), forward flexion (P=.001), and abduction (P=.001) measurements between the groups (P < .05). No significant di!erence was found in internal rotation and Rowe scores between the groups (P=.057, P=.069). A greater improvement was seen in the Rowe score of the ABR+remplissage group (85.2 ± 8.8). No recurrence or complications were observed in any of the patients.
The combined procedure of ABR with remplissage may limit joint mobility in patients with anterior shoulder instability. However, it provides satisfactory functional results, with patients in the ABR+remplissage group showing better overall outcomes.
Level III, Therapeutic study.
本研究旨在探讨单纯关节镜下Bankart修复术（ABR）以及ABR联合补充修复术对肩前不稳患者关节活动范围和功能结果的影响。
这项回顾性研究纳入了1年前接受单纯ABR或ABR联合补充修复术治疗的患者。通过磁共振成像确定Bankart损伤情况，通过计算机断层扫描确定肩胛盂骨缺损量。肩胛盂骨缺损<25%且Hill-Sachs损伤（HSL）在正常轨迹的患者接受单纯ABR治疗（22例女性，8例男性；平均年龄=27.4±6.4岁）。HSL不在正常轨迹的患者接受ABR和补充修复术治疗（20例女性，10例男性；平均年龄=27.5±5.3岁）。手术治疗1年后，使用通用测角器测定患者的关节活动范围，采用Rowe评分评估功能状态。
对60例患者的60个肩关节进行了平均为期1年的评估。两组患者在年龄（P = 0.767）和性别（P = 0.779）方面无差异。共有42例女性和18例男性患者，平均年龄=27.5±5.8岁。两组患者在内收臂时的外旋（ER1）（P = 0.001）、外展臂时的外旋（ER2）（P = 0.001）、前屈（P = 0.001）和外展（P = 0.001）测量值之间存在显著差异（P < 0.05）。两组患者在内旋和Rowe评分方面未发现显著差异（P = 0.057，P = 0.069）。ABR+补充修复术组的Rowe评分改善更大（85.2±8.）。所有患者均未观察到复发或并发症。
ABR联合补充修复术可能会限制肩前不稳患者的关节活动度。然而，它能提供令人满意的功能结果，ABR+补充修复术组患者的总体结局更好。
III级，治疗性研究。
