关节镜下治疗肩关节后向不稳定的中期随访研究

The Mid-term Follow-up Study of the Treatment of Posterior Instability of Shoulder Joint by Arthroscopy

目的评价关节镜治疗肩关节后向不稳定的中期疗效及术前、术中的各种因素对预后的影响。方法方便选取2008年9月—2013年12月在该院治疗的25个连续病例进行回顾性研究。平均年龄30岁（19~41岁）。采用关节镜下缝合锚钉固定（平均3.2个锚钉）,或关节囊紧缩（平均缝合5针）技术。平均随访39个月（18~60个月）。结果采用美国肩肘外科评分,西安大略肩关节不稳定指数来评定。结果共有4例患者失败。其中2例复发不稳定,2例术后持续疼痛。总体结果采用美国肩肘外科评分（ASES）平均为96分,西安大略肩关节不稳定指数（WOSI）平均为401分。肩关节随意性不稳定或者有手术史的患者预后较差。结论肩关节镜治疗肩关节后向不稳定中期疗效良好。对无肩关节手术史的单向的非随意性的肩关节后向不稳定的治疗有满意的疗效。

Objective To evaluate the influence of different factors on the prognosis of the patients with anterior instability of shoulder joint after arthroscopic treatment and the influence of various factors on the prognosis. Methods Convenient se-lection a retrospective study was carried out on 25 consecutive patients who were treated in our department from September 2008 to December 2013. The average age was 30 years （19~41 years）. Arthroscopic suture anchor fixation （mean 3.2 an-chors）, or joint capsule compression （mean suture 5 pin） technique. The average follow-up was 39 months （18~60 months）. Results Using the American Shoulder and Elbow Surgery score, Xi＇an Ontario shoulder instability index evaluation. Results a total of 4 patients failed. Among them, 2 cases recurred and 2 patients continued pain after operation. Overall results us-ing the American Shoulder and Elbow Surgery score （ASES） for an average of 96 points, Western Ontario shoulder not sta-bility index （WOSI） average 401. The prognosis of patients with instability of the shoulder joint and the history of surgery is poor. Conclusion Shoulder arthroscopy in the treatment of shoulder joint posterior instability is good. Satisfactory curative effect on the treatment of non-random shoulder joint after the operation history of non-shoulder joint is satisfactory.