关节镜下应用双排技术修复肩关节骨性Bankart损伤的研究

Arthroscopic repair of shoulder joint bony Bankart injuries with double row technique: a retrospective study

关键词:  肩关节  前脱位  关节镜  双排  微创

Key words:  shoulder joint  anterior dislocation  arthroscope  double row  minimally invasive

摘要:

目的　探讨关节镜下双排技术治疗肩关节骨性Bankart损伤导致肩关节前脱位的手术方法和临床疗效。方法　收集2015年1月至2017年1月在关节镜下应用双排单滑轮技术修复骨性Bankart损伤致肩关节不稳的患者16例，术中采用关节镜下双排技术，应用带线锚钉缝合盂肱下韧带及关节囊于盂唇缺失部位。比较术前及术后Rowes评分、ASES评分、UCLA评分、Constant-murely评分、VAS评分。结果　16例术后未出现再脱位、感染等手术相关并发症，随访12~36个月，平均（22.6±3.41）个月。术后Constant-murely评分、Rowe评分、ASES评分、UCLA评分、VAS评分均显著优于术前，差异均有统计学意义（P<0.05)。结论　关节镜下应用双排技术修复前下方骨性Bankart损伤所致肩关节前脱位，可有效恢复肩关节前方稳定性，运动功能康复良好，是治疗前下方骨性Bankart损伤引起肩关节不稳的较好方法，创伤小，恢复快。

Abstract:

Objective　To explore the operative method and clinical effect of arthroscopic double row technique in the treatment of shoulder joint bony Bankart injury caused by shoulder anterior dislocation. 　Methods　Sixteen cases of shoulder joint instability were analyzed from January 2015 to January 2017 in the application of arthroscopic double-row single pulley technique to repair the bony Bankart, the application of suture anchor under the glenohumeral ligament and joint capsule in labrum deletion. The Rowes score, ASES score, UCLA score, Constant-murely score and VAS score were compared before and after the surgery. 　Results　All the 16 patients were followed up. There were no complications such as redislocation or infection after surgery. The follow-up time was 12-36 months with an average of (22.6±3.41) months. The postoperative Constant-murely score, Rowe score, ASES score, UCLA score and VAS score were all significantly better than those before the surgery. 　Conclusion　Arthroscopic repair with double-row technology of bony Bankart injury caused by shoulder joint anterior dislocation can effectively restore the stability of shoulder joint and improve the recovery of motor function. It is a better method to treat shoulder instability caused by anterior and inferior bony Bankart injury with less trauma and faster recovery.