Geiger D F, Hurley J A, Tovey J A, Rao J P
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI, USA.
Clin Orthop Relat Res. 1997 Apr(337):111-7. doi: 10.1097/00003086-199704000-00013.
The purpose of this study was to compare patients with anterior shoulder instability who were treated with an open Bankart procedure with those treated with an arthroscopic procedure. During a 3-year period, 43 patients (44 shoulders) were surgically treated. Thirty-four patients were available for followup. Eighteen shoulders had open Bankart procedure, and 16 shoulders were treated arthroscopically. Capsular laxity can be better assessed with the open procedure. A Bankart lesion was found in all the patients in both series. Average followup for Group 1 was 34 months, and for Group 2, it was 23 months. Group 1 had 83% good to excellent results with no recurrent dislocation or reoperation. Group 2 had 50% good to excellent results, and 50% fair to poor results with 3 recurrent dislocations and 4 recurrent subluxations that required second operation. The average loss of external rotation in Group 1 was not significantly greater than that in Group 2. Sixteen patients in Group 1 and 8 patients in Group 2 were able to return to their primary work or sport. Results of arthroscopic Bankart repair do not equal those of the open Bankart procedure for the rate of recurrence and postoperative range of motion. The followup reported is short, and more dislocations can be anticipated with longer followup.
本研究的目的是比较接受开放性Bankart手术治疗的前肩不稳患者与接受关节镜手术治疗的患者。在3年期间，43例患者（44个肩部）接受了手术治疗。34例患者可供随访。18个肩部接受了开放性Bankart手术，16个肩部接受了关节镜治疗。开放性手术能更好地评估关节囊松弛情况。两个系列的所有患者均发现有Bankart损伤。第1组的平均随访时间为34个月，第2组为23个月。第1组有83%的患者获得良好至优秀的结果，无复发性脱位或再次手术。第2组有50%的患者获得良好至优秀的结果，50%的患者结果一般至较差，有3例复发性脱位和4例复发性半脱位需要再次手术。第1组的平均外旋丧失程度并不显著大于第2组。第1组有16例患者、第2组有8例患者能够恢复其原来的工作或运动。关节镜下Bankart修复术在复发率和术后活动范围方面的结果不如开放性Bankart手术。所报告的随访时间较短，随着随访时间延长，预计会有更多脱位发生。
