关节镜下非打结型缝合锚钉修补Bankart损伤治疗复发性肩关节前脱位  

Arthroscopic Bankart repair for treatment of recurrent anterior shoulder dislocation with Mitek bio- knotless suture anchors

作　　者：黄华扬[1] 郑小飞[1] 张余[1] 尹庆水[1] 

机构地区：[1]广州军区广州总医院骨科,510010

出　　处：《中华骨科杂志》2008年第11期912-916,共5页Chinese Journal of Orthopaedics

摘　　要：目的探讨关节镜下非打结型缝合锚钉修补Bankart损伤治疗复发性肩关节前脱位的疗效。方法复发性肩关节前脱位患者14例，均为男性；年龄18-34岁，平均25．2岁；左侧4例，右侧10例，涉及主力侧12例；均为单向不稳。术前脱位次数为3～36次，平均13．5次。关节镜下采用可吸收非打结型缝合锚钉治疗Bankart损伤。术前及术后随访采用ASES评分及Constant-Murley功能评估。结果所有患者均获得随访，随访时问11～22个月，平均17个月。术中发现9例合并Hill-Sachs损伤，3例合并骨性Bankart损伤，2例合并后下盂唇损伤，2例合并SLAPⅡ型损伤，1例合并关节内游离体。14例患者术前及末次随访时肩关节平均前屈上举为163．4°±8．6°和169．7°±4．2°；外展90°时，平均外旋角度分别为58．5°±13．6°和90.3°±5．5°；术后外展90°时，患侧外旋角度较健侧受限8．4°±6．2°。术前及末次随访时ASES评分为（77．4±3．7）分和（94.3±2．6）分，两者比较差异有统计学意义（P〈0．05）；其中VAS不稳定评分平均为（7．2±1．4）分和（1．2±0．6）分（P〈0．01）；Constant—Murley评分平均为（78．1±4．6）分和（93．9±3．7）分。术后无一例患者发生再脱位，且均重返伤前工作岗位。结论肩关节镜下Bankart重建手术是治疗复发性肩关节脱位的有效方法。非打结型缝合锚钉简化了手术操作步骤，减少手术时间和创伤。Objective To investigate the clinical results of arthroscopic Bankart repair for the treatment of reeurrent anterior shoulder dislocation with Mitek bioknotless suture anchors. Methods Fourteen patients of recurrent anterior shoulder dislocation were treated by arthroseopic Bankart repair with Mitek bioknotless suture anchors. All patients had unidirectional instabilities on the dominant sides. The average age at surgerywas 25.2 years （range, 18-34 years）. The mean times of dislocations before surgery were 13.5 （range, 3-36）. American Shoulder and Elbow Surgeons（ASES） and Constant-Murley seore were adopted for final evaluation at the last follow-up. Results The mean follow-up period was 17 months （range, 11-22 months）. A Hill-Sachs lesion was observed in 9 patients. A bony Bankart lesion was found in 3 patients. A type Ⅱ SLAP lesion was assoeiated in 2 patients and treated with arthroseopic fixation. A posterior-inferior labral lesion was found in 2 patients and treated with arthroseopie debridement. A joint mouse was removed in 1 patient. The mean forward flexion was 163.4°±8.6° and 169.7°±4.2° pre-and postoperatively. The mean external rotation in 90° abduction was 58.5°±13.6° and 90.3°±5.5° pre- and postoperatively, which was less 8.4°±6.2° than that of normal side shoulder postoperatively. The pre- and postoperative mean ASES score was 77.4±3.7 and 94.3±2.6, the mean VAS instability seore were 7.2±1.4 and 1.2±0.6. The pre- and postoperative mean Constant-Murley score was 78.1±4.6 and 93.9±3.7. All patients did not suffer postoperative s houlder dislocation. All patients returned to their pre-injury works. Conclusion Arthroseopie Bankart repair with Mitek bioknotless suture anchors is a good option for treating recurrent anterior shoulder dislocation.

关 键 词：关节镜检查 肩脱位 骨螺丝 

分 类 号：R686[医药卫生—骨科学]