关节镜下带线锚钉垂直褥式缝合修复Bankart损伤

Arthroscopic Bankart lesion repair by double-row vertical mattress suture with anchors for anteroinferior glenohumeral instability

目的介绍关节镜下带线锚钉垂直褥式缝合修复 Bankart 损伤技术,并评价其临床疗效。方法关节镜下带线锚钉垂直褥式缝合修复 Bankart 损伤技术操作步骤:于肩胛盂缘3点和5点钟位置分别植入2枚带线锚钉,分别在盂唇2点、4点和6点位置将盂唇韧带复合体进行垂直褥式缝合,并将其前下方关节囊向上转移。2004年4月至2006年8月收治的9例盂肱关节前向不稳定患者均无严重的肩胛盂骨性缺损,手术时平均年龄28岁(21～46岁)。采用 Rowe 肩关节修正评分进行临床随访,平均随访时间14个月(6～26个月)。Rowe 肩关节修正评分术前(40±16)分。结果手术时间平均为51 min(40～75 min)。术后 Rowe 肩关节修正评分上升至(92±19)分(75～94分)。随访期间无复发,也未发生并发症,0°外展时外旋平均减少5°,90°外展时外旋平均减少3°。结论关节镜下带线锚钉垂直褥式缝合修复 Bankart 损伤治疗盂肱关节前下不稳定手术技术相对简单、手术时间短、近期临床效果较好。

Objectives To introduce a new arthrescopic Bankart repair by vertical mattress suture with anchors, and to evaluate its clinical effectiveness. Methods A new arthroscopic Bankart repair by vertical mattress suture with anchors was performed, including to insert only 2 anchors at 3 o＇clock and 5 o＇clock position and make vertical mattress suture of labrum-ligament complex at 2, 4 and 6 o＇ clock of labrum, and to shift up the anterior-inferior capsule. Nine cases of anterior glenohumeral instability without severe glenoid bone defect were followed-up for an average period of 14 months （range from 6 to 26 months）. The average surgery age was 28 years （ range from 21 to 46 years）. Results The average surgery time was 51 min （40 -75 min）. Clinical scores as evaluated by the modified Rowe score advanced from 40 ± 16 points to 92 ± 19 points （75 -94）. There was no any recurrence and complication. External rotation was reduced by 5° at 0°adduction and by 3°at 90° of abduction. Conclusions The arthroscopic Bankart repair by vertical mattress suture with anchors for anteroinferior glenohumeral instability is favorable as an easy, short-time surgery with excellent clinical results in short-term follow-up.