Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Meth...Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Methods: A total of 14 patients who underwent open or arthroscopic Bankart repair with an initial presentation of traumatic shoulder instability between January 2010 and January 2017 and admitted to our center with complaints due to poorly positioned and/or proud metallic suture anchors were enrolled. Pre- and intraoperative findings, surgical outcomes and complications were reviewed. Diagnosis of proud or poorly positioned suture anchors was established using magnetic resonance imaging (MRI) of shoulder in five cases, and with shoulder arthroscopy in nine patients. Outcomes were measured by the use of the CONSTANT score and American Shoulder and Elbow Society (ASES) score. Results: Eleven male and three female patients with an average age of 29.21 ± 5.78 (range, 20 to 42) were enrolled in the present study. Revision Bankart repair was performed arthroscopically in all patients. The mean follow-up period was 40.4 months, ranging from 18 to 64 months. The preoperative Constant and ASES scores were 68.43 ± 7.05 and 38.3 ± 19.4, respectively. Postoperatively, the scores were 89.64 ± 5.39 and 89.07 ± 3.89, respectively (p Conclusion: To conclude, arthroscopy may yield an effective surgical option for removal of poorly positioned and/or proud metallic suture anchors after Bankart repair. However, further clinical reports on larger series are warranted to document the efficacy of this procedure in selected cases.展开更多
BACKGROUND With stiff competition from alternative albeit more expensive counterparts,it has become important to establish the applicability of metallic anchors for shoulder instability in the modern era.This can be a...BACKGROUND With stiff competition from alternative albeit more expensive counterparts,it has become important to establish the applicability of metallic anchors for shoulder instability in the modern era.This can be accomplished,in part,by analysing long-term outcomes.AIM To analyse minimum 10-year outcomes from 30 patients following arthroscopic anterior stabilisation using metallic anchors.METHODS Prospectively collected data from arthroscopic Bankart repairs performed using metal anchors during 2007P-2010 were retrospectively analysed in this singlesurgeon study.Comprehensive data collection included historical and clinical findings,dislocation details,operative specifics,and follow-up radiological and clinical findings including shoulder scores.The primary outcomes were patientreported scores(Constant,American Shoulder and Elbow Surgeons[ASES],and Rowe scores)and pain and instability on a visual analogue scale(VAS).RESULTS A 3% recurrence rate of dislocation was noted at the final follow-up.Total constant scores at 10 years postoperatively measured between 76 and 100(mean 89)were significantly better than preoperative scores(mean 62.7).Congruous improvements were also noted in the Rowe and ASES scores and VAS at the 10-year review.CONCLUSION Reliable long-term outcomes with metallic anchors in surgery for shoulder instability can be expected.Our results provide additional evidence of their continued,cost-effective presence in the modern scenario.展开更多
目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前...目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。展开更多
目的探讨关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效。方法回顾性分析2017年1月—2021年6月符合选择标准的107例复发性肩关节前脱位患者临床资料,均接受关节镜下Bankart修复术。男88例,女19例;患者初次脱位年龄13~48岁,平...目的探讨关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效。方法回顾性分析2017年1月—2021年6月符合选择标准的107例复发性肩关节前脱位患者临床资料,均接受关节镜下Bankart修复术。男88例,女19例;患者初次脱位年龄13~48岁,平均23.3岁;脱位次数2~160次,中位次数7次;病程0.2~240.0个月,中位病程36.0个月。手术时年龄16~61岁,平均28.2岁。左肩43例,右肩64例。63例合并关节盂骨缺损,骨缺损达1.7%~16.1%,平均8.1%。MRI检查示均不合并肩袖撕裂和肩关节僵硬。术后1 d行CT三维重建检查,评估植入锚钉分布以及锚钉植入处有无关节盂劈裂骨折和拔钉等情况发生。观察术后并发症发生情况,采用疼痛视觉模拟评分(VAS)、Rowe评分、Constant-Murley评分、美国肩肘外科医师协会(ASES)评分评估患肩疼痛及功能。记录术后患者肩关节不稳复发情况、恐惧试验结果、恢复至术前运动水平患者例数以及患者自评满意度。结果手术均顺利完成。患者均获随访,随访时间20~73个月,平均41.5个月。术后切口均Ⅰ期愈合。术后1 d CT三维重建检查示,锚钉均位于2∶00~5∶30区域且在关节盂表面边缘,无拔钉及锚钉植入处劈裂骨折发生。末次随访时,VAS评分低于术前,Rowe评分、Constant-Murley评分及ASES评分均较术前增高,差异有统计学意义(P<0.05)。7例(6.5%)于术后23~55个月肩关节前脱位复发,平均39.9个月;其中脱位6例、半脱位1例。末次随访时,51例患者(47.7%)恢复至术前运动水平,11例(10.3%)恐惧试验阳性。患者自评满意率为90.7%(97/107);10例手术效果不满意者中,7例术后肩关节不稳复发,3例自觉未恢复至术前运动水平。结论对于关节盂骨缺损少、运动需求不高的复发性肩关节前脱位患者,关节镜下Bankart修复术治疗可获得良好的中期疗效。展开更多
目的考察Bankart合并关节盂上唇从前至后部(superior labrum anterior to posterior,SLAP)损伤的复发性肩关节脱位患者采用关节镜修复手术治疗的临床效果。方法回顾分析2011年5月至2015年1月间因复发性肩关节脱位接受关节镜下Bankart联...目的考察Bankart合并关节盂上唇从前至后部(superior labrum anterior to posterior,SLAP)损伤的复发性肩关节脱位患者采用关节镜修复手术治疗的临床效果。方法回顾分析2011年5月至2015年1月间因复发性肩关节脱位接受关节镜下Bankart联合SLAP损伤修复治疗的15例患者临床资料,将其作为试验组研究对象。患者平均年龄为24.2岁(16~38岁)。术中首先采用可吸收缝合锚钉对不稳定的SLAP损伤进行修复固定,之后再修复Bankart损伤。另选取15例单纯Bankart损伤接受关节镜修复治疗的复发性肩关节脱位患者作为对照组研究对象,患者的平均年龄为24.6(18~35岁)。在术前及末次随访时,采用视觉模拟评分(Visual Analogue Scale,VAS)、美国肩肘关节外科医师评分(American Shoulder and Elbow Surgeons,ASES)、Rowe肩关节评分以及肩关节活动度等对两组患者临床效果进行评估。结果试验组的平均随访时间为15个月(13~28个月),对照组为22个月(21~34个月)。试验组平均VAS评分从术前4.9降低到末次随访时的1.9,差异有统计学意义(P<0.05);平均ASES评分和Rowe肩关节评分分别从术前的33.7和56.4提高到末次随访时91.8和94.1,差异均有统计学意义(P<0.05);在VAS评分、ASES评分以及Rowe评分方面,术前及术后随访时,两组之间差异均无统计学意义(P>0.05)。到末次随访时,两组所有病例均未再次出现复发性脱位,经物理检查亦未证实肩关节不稳存在。两组所有病例患侧肩关节的前屈、外展、内旋活动度均恢复至正常水平。结论关节镜下Bankart联合SLAP损伤可吸收缝合锚钉固定修复治疗复发性肩关节不稳临床效果满意,可有效重建患者肩关节稳定,改善肩关节功能。展开更多
文摘Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Methods: A total of 14 patients who underwent open or arthroscopic Bankart repair with an initial presentation of traumatic shoulder instability between January 2010 and January 2017 and admitted to our center with complaints due to poorly positioned and/or proud metallic suture anchors were enrolled. Pre- and intraoperative findings, surgical outcomes and complications were reviewed. Diagnosis of proud or poorly positioned suture anchors was established using magnetic resonance imaging (MRI) of shoulder in five cases, and with shoulder arthroscopy in nine patients. Outcomes were measured by the use of the CONSTANT score and American Shoulder and Elbow Society (ASES) score. Results: Eleven male and three female patients with an average age of 29.21 ± 5.78 (range, 20 to 42) were enrolled in the present study. Revision Bankart repair was performed arthroscopically in all patients. The mean follow-up period was 40.4 months, ranging from 18 to 64 months. The preoperative Constant and ASES scores were 68.43 ± 7.05 and 38.3 ± 19.4, respectively. Postoperatively, the scores were 89.64 ± 5.39 and 89.07 ± 3.89, respectively (p Conclusion: To conclude, arthroscopy may yield an effective surgical option for removal of poorly positioned and/or proud metallic suture anchors after Bankart repair. However, further clinical reports on larger series are warranted to document the efficacy of this procedure in selected cases.
文摘BACKGROUND With stiff competition from alternative albeit more expensive counterparts,it has become important to establish the applicability of metallic anchors for shoulder instability in the modern era.This can be accomplished,in part,by analysing long-term outcomes.AIM To analyse minimum 10-year outcomes from 30 patients following arthroscopic anterior stabilisation using metallic anchors.METHODS Prospectively collected data from arthroscopic Bankart repairs performed using metal anchors during 2007P-2010 were retrospectively analysed in this singlesurgeon study.Comprehensive data collection included historical and clinical findings,dislocation details,operative specifics,and follow-up radiological and clinical findings including shoulder scores.The primary outcomes were patientreported scores(Constant,American Shoulder and Elbow Surgeons[ASES],and Rowe scores)and pain and instability on a visual analogue scale(VAS).RESULTS A 3% recurrence rate of dislocation was noted at the final follow-up.Total constant scores at 10 years postoperatively measured between 76 and 100(mean 89)were significantly better than preoperative scores(mean 62.7).Congruous improvements were also noted in the Rowe and ASES scores and VAS at the 10-year review.CONCLUSION Reliable long-term outcomes with metallic anchors in surgery for shoulder instability can be expected.Our results provide additional evidence of their continued,cost-effective presence in the modern scenario.
文摘目的观察电针联合手牵足蹬手法复位对初次肩关节脱位患者肩关节功能的影响。方法将78例初次肩关节脱位的患者,随机分为对照组和观察组,每组39例。对照组采用手牵足蹬法复位进行治疗,观察组在对照组的基础上联合电针治疗。观察两组治疗前后Neer肩关节功能评分、Rowe氏评分系统中稳定性及活动度评分、肩关节角度及治疗前、出院时和出院后1个月疼痛视觉模拟量表(visual analog scale,VAS)评分变化,并比较两组不良反应发生率。结果治疗后,两组Neer肩关节功能评分各项评分及总分均升高(P<0.05),且观察组疼痛和运动范围评分及总分高于对照组(P<0.05);两组Rowe氏评分中的稳定性和活动度评分均升高(P<0.05),且观察组高于对照组(P<0.05);两组前屈上举、外展外旋角度均增大(P<0.05),且观察组大于对照组(P<0.05),两组体侧外旋角度比较差异无统计学意义(P>0.05)。两组出院时、出院后1个月VAS评分均低于治疗前,且观察组出院时、出院后1个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合手牵足蹬手法复位可改善初次肩关节脱位患者的肩关节功能及疼痛情况,无明显不良反应,是一种安全、有效的治疗方法。
文摘目的探讨关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效。方法回顾性分析2017年1月—2021年6月符合选择标准的107例复发性肩关节前脱位患者临床资料,均接受关节镜下Bankart修复术。男88例,女19例;患者初次脱位年龄13~48岁,平均23.3岁;脱位次数2~160次,中位次数7次;病程0.2~240.0个月,中位病程36.0个月。手术时年龄16~61岁,平均28.2岁。左肩43例,右肩64例。63例合并关节盂骨缺损,骨缺损达1.7%~16.1%,平均8.1%。MRI检查示均不合并肩袖撕裂和肩关节僵硬。术后1 d行CT三维重建检查,评估植入锚钉分布以及锚钉植入处有无关节盂劈裂骨折和拔钉等情况发生。观察术后并发症发生情况,采用疼痛视觉模拟评分(VAS)、Rowe评分、Constant-Murley评分、美国肩肘外科医师协会(ASES)评分评估患肩疼痛及功能。记录术后患者肩关节不稳复发情况、恐惧试验结果、恢复至术前运动水平患者例数以及患者自评满意度。结果手术均顺利完成。患者均获随访,随访时间20~73个月,平均41.5个月。术后切口均Ⅰ期愈合。术后1 d CT三维重建检查示,锚钉均位于2∶00~5∶30区域且在关节盂表面边缘,无拔钉及锚钉植入处劈裂骨折发生。末次随访时,VAS评分低于术前,Rowe评分、Constant-Murley评分及ASES评分均较术前增高,差异有统计学意义(P<0.05)。7例(6.5%)于术后23~55个月肩关节前脱位复发,平均39.9个月;其中脱位6例、半脱位1例。末次随访时,51例患者(47.7%)恢复至术前运动水平,11例(10.3%)恐惧试验阳性。患者自评满意率为90.7%(97/107);10例手术效果不满意者中,7例术后肩关节不稳复发,3例自觉未恢复至术前运动水平。结论对于关节盂骨缺损少、运动需求不高的复发性肩关节前脱位患者,关节镜下Bankart修复术治疗可获得良好的中期疗效。
