Arthroscopy with subscapularis upper one-third tenodesis for treatment of recurrent anterior shoulder instability independent of glenoid bone loss  

作　　者：Bai-Jing An Feng-Lin Wang Yao-Ting Wang Zhe Zhao Ming-Xin Wang Geng-Yan Xing 

机构地区：[1]Department of Sports Medicine,The Fourth Medical Center,PLA General Hospital,Beijing 100048,China [2]Department of Clinical Laboratory,The Third Medical Center,PLA General Hospital,Beijing 100039,China [3]Department of Orthopedics,The Third Medical Center,PLA General Hospital,Beijing 100039,China

出　　处：《World Journal of Clinical Cases》2022年第25期8854-8862,共9页世界临床病例杂志

摘　　要：BACKGROUND Recurrent anterior shoulder instability is a common traumatic injury,the main clinical manifestation of which is recurrent anteroinferior dislocation of the humeral head.The current follow-up study showed that the effect of arthroscopic Bankart repair is unreliable.AIM To evaluate the clinical efficacy of arthroscopy with subscapularis upper one-third tenodesis for treatment of anterior shoulder instability,and to develop a method to further improve anterior stability and reduce the recurrence rate.METHODS Between January 2015 and December 2018,male patients with recurrent anterior shoulder instability were selected.One hundred and twenty patients had a glenoid defect<20%and 80 patients had a glenoid defect>20%.The average age was 25 years(range,18–45 years).Patients with a glenoid defect<20%underwent arthroscopic Bankart repair with a subscapularis upper one-third tenodesis.The patients with a glenoid defect>20%underwent an arthroscopic iliac crest bone autograft with a subscapularis upper one-third tenodesis.All patients were assessed with Rowe and Constant scores.RESULTS The average shoulder forward flexion angle was 163.6°±8.3°and 171.8°±3.6°preoperatively and at the last follow-up evaluation,respectively.The average external rotation angle when abduction was 90°was 68.4°±13.6°and 88.5°±6.2°preoperatively and at the last follow-up evaluation,respectively.The mean Rowe scores preoperatively and at the last follow-up evaluation were 32.6±3.2 and 95.2±2.2,respectively(P<0.05).The mean Constant scores preoperatively and at the last follow-up evaluation were 75.4±3.5 and 95.8±3.3,respectively(P<0.05).No postoperative dislocations were recorded by the end of the follow-up period.CONCLUSION Arthroscopy with subscapularis upper one-third tenodesis was effective for treatment of recurrent anterior shoulder instability independent of the size of the glenoid bone defect,enhanced anterior stability of the shoulder,and did not affect postoperative range of motion of the affected limb.

关 键 词：ARTHROSCOPY SUBSCAPULARIS Iliac crest bone autograft Recurrent anterior shoulder instability Glenoid bone loss 

分 类 号：R687.2[医药卫生—骨科学]