Suture anchor を用いた鏡視下 Bankart 法術後再(亜)脱臼例の検討 : 初回手術時の病態と再手術所見よりみたその対策

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The purpose of this study was to analyze the characteristics of redislocation/subluxation cases after arthroscopic Bankart repair using suture anchors through the findings during revision arthroscopic surgery and three-dimensional computed tomography (3DCT) of the glenoid. Thirteen out of 150 shoulders experienced redislocation/subluxation. All of them had resumed their former sports levels and were reinjured during a sports activity. The average age at the time of reinjury was 19.2 (range, 15-28) years old and the average period from the initial surgery was 9.2 (range, 2-22) months. Twelve out of 13 shoulders were reinjured less than 13 months from the initial surgery and 4 shoulders less than 6 months. 3DCT of the glenoid revealed poorer morphology of the antero-inferior part of the glenoid rim in 10 out of 11 shoulders, including acute glenoid rim fracture in 4 shoulders, compared with the 3DCT performed prior to initial surgery. Suture breakage without knot/anchor failure was observed in every shoulder during revision arthroscopic surgery performed in 8 shoulders. In 4 acute glenoid rim fracture cases, the reconstructed labro-ligamentous complex during initial surgery was firmly attached to the bony fragment. We conclude that it is important to obtain initial strength by suture augmentation and to retain glenoid rim morphology by ”bony Bankart repair” in cases of bone defect during initial surgery, especially in high-demand athletes. In high risk cases such as poor glenoid morphology, arthroscopic rotator interval closure is recommended in addition to the intra-articular anatomical repairs.
日本肩関節学会の論文
2002-01-01

Suture anchor を用いた鏡視下 Bankart 法術後再(亜)脱臼例の検討 : 初回手術時の病態と再手術所見よりみたその対策

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