[1]孙奔奔,何耀华#,沈 继,等.关节镜下Bankart修复术的临床疗效及术后复发危险因素[J].郑州大学学报(医学版),2017,(05):645-649.[doi:10.13705/j.issn.1671-6825.2017.05.032]
 SUN Benben,HE Yaohua,SHEN Ji,et al.Clinical efficacy of arthroscopic Bankart repair and the risk factors for postoperative recurrence[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(05):645-649.[doi:10.13705/j.issn.1671-6825.2017.05.032]
点击复制

关节镜下Bankart修复术的临床疗效及术后复发危险因素()
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年05期
页码:
645-649
栏目:
应用研究
出版日期:
2017-09-15

文章信息/Info

Title:
Clinical efficacy of arthroscopic Bankart repair and the risk factors for postoperative recurrence
作者:
孙奔奔何耀华#沈 继丁振禹章志望
上海交通大学附属第六人民医院骨科 上海 200233
Author(s):
SUN Benben HE Yaohua SHEN Ji DING Zhenyu ZHANG Zhiwang
Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233
关键词:
肩关节不稳 关节镜 Bankart修复术 危险因素
Keywords:
shoulder instability arthroscopy Bankart repair risk factors
分类号:
R684
DOI:
10.13705/j.issn.1671-6825.2017.05.032
摘要:
目的:探讨关节镜下Bankart修复术治疗肩关节前向不稳的中长期疗效,并分析术后复发的危险因素。方法:对2012年3月至2016年3月收治的115例行关节镜下Bankart修复术的肩关节前向不稳患者进行回顾性研究; 其中男81例,女34例,年龄16~70(29.1±8.2)岁。随访采用Constant-Murley评分、Rowe评分及美国肩肘外科学会(ASES)评分评估手术疗效。采用logistic回归分析术后肩关节不稳复发的危险因素。结果:115例患者术后随访12~60个月; 末次随访Constant-Murley评分、ASES评分及Rowe评分均较术前提高(P<0.001)。13例术后复发,总体复发率为11.3%; logistic回归分析显示:手术时年龄≤20岁、参加过顶或对抗性运动、肩胛盂骨缺损是关节镜下Bankart修复术术后复发的独立危险因素,其OR(95%CI)分别为4.786(1.035~22.125)、9.481(1.791~50.202)、4.500(1.053~19.229)。结论:关节镜下Bankart修复术治疗复发性肩关节前向不稳临床疗效满意; 手术时年龄≤20岁、参加过顶或对抗性运动、肩胛盂骨缺损是术后复发的危险因素。
Abstract:
Aim: To evaluate the clinical efficacy of arthroscopic Bankart repair in the management of anterior shoulder instability and assess the risk factors for postoperative recurrence.Methods: A total of 115 recurrent anterior shoulder instability patients with arthroscopic Bankart repair from March 2012 to March 2016 were collected. There were 81 males and 34 females with an age range from 16 to 70(29.1±8.2)years. American Shoulder and Elbow Surgeons(ASES)shoulder score, Constant-Murley shoulder score and Rowe score were used to evaluate the clinical efficacy preoperatively and postoperatively. The risk factors were analyzed by logistic regression.Results: The 115 patients acquired 12-60 month follow-up. The ASES score, Constant-Murley score and the Rowe score in last follow-up improved significantly(P<0.001). Thirteen patients had a postoperative recurrence with the postoperative recurrence rate of 11.3%. The logistic regression showed that under 20 years when accepting surgery, overhead or contact sports, and glenoid defects were independent risk factors for recurrence of shoulder instability, and the OR(95%CI) were 4.786(1.035-22.125), 9.481(1.791-50.202)and 4.500(1.053-19.229), separately.Conclusion: Arthroscopic Bankart repair achieved a satisfactory efficacy in the treatment of anterior shoulder instability. Under 20 years when accepting surgery, overhead or contact sports, and glenoid defects are important risk factors for recurrence.

参考文献/References:

[1] MILEWSKI MD,NISSEN CW.Pediatric and adolescent shoulder instability[J].Clin Sports Med,2013,32(4):761
[2] BANKART AS.The pathology and treatment of recurrent dislocation of the shoulder-joint[J].Br J Surg,1938,26(101):23
[3] KIM SH,HA KI,CHO YB,et al.Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up[J].J Bone Joint Surg Am,2003,85-A(8):1511
[4] VAN DER LINDE JA,VAN KAMPEN DA,TERWEE CB,et al.Long-term results after arthroscopic shoulder stabilization using suture anchors: an 8- to 10-year follow-up[J].Am J Sports Med,2011,39(11):2396
[5] BURKHEAD WZ,ROCKWOOD CA.Treatment of instability of the shoulder with an exercise program[J].J Bone Joint Surg Am,1992,74(6):890
[6] LAFOSSE L,LEJEUNE E,BOUCHARD A,et al.The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability[J].Arthroscopy,2007,23(11):1242.e1
[7] DUMONT GD,FOGERTY S,ROSSO C,et al.The arthroscopic latarjet procedure for anterior shoulder instability: 5-year minimum follow-up[J].Am J Sports Med,2014,42(11):2560
[8] BOILEAU P,BICKNELL RT,EL FEGOUN AB,et al.Arthroscopic Bristow procedure for anterior instability in shoulders with a stretched or deficient capsule: the "belt-and-suspenders" operative technique and preliminary results[J].Arthroscopy,2007,23(6):593
[9] ABOALATA M,PLATH JE,SEPPEL G,et al.Results of arthroscopic Bankart repair for anterior-inferior shoulder instability at 13-year follow-up[J].Am J Sports Med,2017,45(4):782
[10]HOVELIUS L,AUGUSTINI BG,FREDIN H,et al.Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study[J].J Bone Joint Surg Am,1996,78(11):1677
[11]PHADNIS J,ARNOLD C,ELMORSY A,et al.Utility of the instability severity index score in predicting failure after arthroscopic anterior stabilization of the shoulder[J].Am J Sports Med,2015,43(8):1983
[12]BALG F,BOILEAU P.The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation[J].J Bone Joint Surg Br,2007,89(11):1470
[13]RHEE YG,HA JH,CHO NS.Anterior shoulder stabilization in collision athletes: arthroscopic versus open Bankart repair[J].Am J Sports Med,2006,34(6):979
[14]MILCHTEIM C,TUCKER SA,NYE DD,et al.Outcomes of Bankart repairs using modern arthroscopic technique in an athletic population[J].Arthroscopy,2016,32(7):1263
[15]ARCIERO RA,PARRINO A,BERNHARDSON AS,et al.The effect of a combined glenoid and Hill-Sachs defect on glenohumeral stability: a biomechanical cadaveric study using 3-dimensional modeling of 142 patients[J].Am J Sports Med,2015,43(6):1422
[16]NAKAGAWA S,OZAKI R,TAKE Y,et al.Relationship between glenoid defects and Hill-Sachs lesions in shoulders with traumatic anterior instability[J].Am J Sports Med,2015,43(11):2763
[17]MOHTADI NG,CHAN DS,HOLLINSHEAD RM,et al.A randomized clinical trial comparing open and arthroscopic stabilization for recurrent traumatic anterior shoulder instability: two-year follow-up with disease-specific quality-of-life outcomes[J].J Bone Joint Surg Am,2014,96(5):353
[18]MILANO G,GRASSO A,SANTAGADA DA,et al.Comparison between metal and biodegradable suture anchors in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study[J].Knee Surg Sports Traumatol Arthrosc,2010,18(12):1785
[19]IMHOFF AB,ANSAH P,TISCHER T,et al.Arthroscopic repair of anterior-inferior glenohumeral instability using a portal at the 5:30-o'clock position: analysis of the effects of age, fixation method, and concomitant shoulder injury on surgical outcomes[J].Am J Sports Med,2010,38(9):1795

备注/Memo

备注/Memo:
#通信作者,男,1970年1月生,博士,主任医师,研究方向:运动医学,E-mail:heyaohuavip@163.com
更新日期/Last Update: 2017-09-20