半月板缝合过线枪在关节镜下Bankart修复中的临床应用

Clinical application of Fastpass Scorpion suture passer for arthroscopic Bankart repair

目的与传统缝合钩比较,探讨关节镜下Bankart修复中采用半月板缝合过线枪缝合下方关节囊盂唇复合体的疗效及优势。方法回顾性分析2019年8月—2021年10月收治且符合选择标准的41例肩关节Bankart损伤患者临床资料。其中,27例关节镜下采用半月板缝合过线枪缝合下方关节囊盂唇复合体(缝合枪组),14例采用缝合钩(缝合钩组)。两组患者性别、年龄、损伤侧别、肩关节脱位次数、首次脱位至手术时间以及术前Rowe肩关节评分等基线资料比较,差异均无统计学意义(P>0.05)。以能成功过线缝合并实现提拉紧缩为完成修复标准,记录并比较两组在关节盂5∶00~6∶00(<6∶00)、6∶00~7∶00位置完成修复的例数;同时记录手术时间和手术前后Rowe肩关节评分差值、肩关节再脱位、恐惧试验及恢复至伤前运动水平情况。结果两组在5∶00~6∶00(<6∶00)位置均完成修复,6∶00~7∶00位置缝合枪组完成修复构成比多于缝合钩组(P<0.05)。缝合枪组手术时间较缝合钩组缩短(P<0.05)。术后切口均Ⅰ期愈合。两组患者均获随访,随访时间12~36个月,平均19.1个月。随访期间无锚钉移位、神经血管损伤等并发症发生。两组患者术后1年Rowe肩关节评分均较术前明显改善(P<0.05),但手术前后差值组间比较差异无统计学意义(P>0.05)。两组术后1年均未出现肩关节再脱位,恐惧试验以及恢复至伤前运动水平情况差异无统计学意义(P>0.05)。结论与使用缝合钩相比,关节镜下Bankart修复中使用半月板缝合过线枪行下方关节囊盂唇复合体缝合过线,操作更简便,手术时间缩短,且修复效果确切。

Objective To explore the effectiveness and advantages of using Fastpass Scorpion suture passer to stitch the inferior capsulolabral complex in arthroscopic Bankart repair compared with traditional arthroscopic suture shuttle.Methods The clinical data of 41 patients with Bankart lesion,who met the selection criteria and were admitted between August 2019 and October 2021,was retrospectively analyzed.Under arthroscopy,the inferior capsulolabral complex was stitched with Fastpass Scorpion suture passer in 27 patients(FS group)and with arthroscopic suture shuttle in 14 patients(ASS group).There was no significant difference between the two groups(P>0.05)in gender,age,injured side,frequency of shoulder dislocation,time from first dislocation to operation,and preoperative Rowe score of shoulder.Taking successful suture and pull-tightening as the criteria for completion of repair,the number of patients that were repaired at 5∶00 to 6∶00(<6:00)and 6∶00 to 7∶00 positions of the glenoid in the two groups was compared.The operation time,and the difference of Rowe shoulder score betwee pre-and post-operation,the occurrence of shoulder joint dislocation,the results of apprehension test,and the constituent ratio of recovery to the pre-injury movement level between the two groups at 1 year after operation.Results Both groups completed the repair at 5∶00 to 6∶00(<6∶00),and the constituent ratio of patients completed at 6∶00 to 7∶00 was significantly greater in the FS group than in the ASS group(P<0.05).The operation time was significantly shorter in the FS group than in the ASS group(P<0.05).All incisions in the two groups healed by first intention.All patients were followed up 12-36 months(mean,19.1 months).No anchor displacement or neurovascular injury occurred during follow-up.Rowe score of shoulder in the two groups significantly improved at 1 year after operation than preoperative scores(P<0.05),and there was no significant difference in the difference of Rowe shoulder score between pre-and post-operation between the two groups(P>0.05).At 1 year after operation,no re-dislocation occurred,and there was no significant difference in the apprehension test and the constituent ratio of recovery to the pre-injury movement level between the two groups(P>0.05).Conclusion Compared with the arthroscopic suture shuttle,using Fastpass Scorpion suture passer to stitch the inferior capsulolabral complex in arthroscopic Bankart repair is more convenient,saves operation time,and has good effectiveness.