Salmon J M, Bell S N
Monash Medical Center, Melbourne, Australia.
Arthroscopy. 1998 Mar;14(2):143-7. doi: 10.1016/s0749-8063(98)70032-5.
Many studies report the results of arthroscopic stabilization for recurrent shoulder instability, with widely variable recurrence rates; however, there are very few reports of the use of these techniques in acute first-time dislocations. We report the clinical outcomes of 17 patients who had arthroscopic stabilization using a transglenoid suture technique for acute primary dislocation. The surgery took place between March 1992 and March 1994 and, to date, there has been one recurrent dislocation (6%) and no recurrent subluxation. There were no major complications, although a number of patients found the knot tied over the infraspinatus fascia to be uncomfortable until it resorbed. All patients examined had normal power and range of motion, and a clinically stable shoulder. All 16 patients without recurrence were satisfied with their result. Nine patients returned to sports at the same or higher level, including such vigorous contact sports as Australian Rules football and rugby. Three patients did not return to the same level of sporting activity because of lack of confidence in the shoulder or a fear of dislocation despite no clinical evidence of instability. Five patients reported a lack of confidence in the shoulder without clinical evidence of instability. We suggest that arthroscopic stabilization with transglenoid sutures or a suture anchor technique is a reasonable option for the athlete with an acute primary shoulder dislocation who wishes to return to sports.
许多研究报告了关节镜下稳定术治疗复发性肩关节不稳定的结果,复发率差异很大;然而,关于这些技术在急性首次脱位中的应用报道却很少。我们报告了17例采用经关节盂缝合技术进行关节镜下稳定术治疗急性原发性脱位患者的临床结果。手术于1992年3月至1994年3月进行,迄今为止,有1例复发性脱位(6%),无复发性半脱位。虽无重大并发症,但有一些患者觉得在冈下肌筋膜上打的结在吸收之前让人不舒服。所有接受检查的患者肌力和活动范围均正常,肩关节临床稳定。所有16例未复发的患者对其结果满意。9例患者恢复到相同或更高水平的运动,包括澳大利亚式足球和橄榄球等剧烈的接触性运动。3例患者因对肩部缺乏信心或担心脱位而未恢复到相同水平的体育活动,尽管没有不稳定的临床证据。5例患者报告对肩部缺乏信心,但无不稳定的临床证据。我们认为,对于希望恢复运动的急性原发性肩关节脱位运动员,经关节盂缝合或缝合锚技术进行关节镜下稳定术是一种合理的选择。