鏡視下バンカート修復術のラーニングカーブの検討 : 手術習熟度の目安

概要

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Arthroscopic Bankart repair requires a certain level of technical proficiency. Takeda evaluated the learning curve regarding arthroscopic Bankart repair, and reported that experience of about 100 cases is necessary to produce certain results. We evaluated the learning curve of arthroscopic Bankart repair, while giving consideration to the degree of surgical difficulty. The subjects consisted of 119 patients who underwent arthroscopic Bankart repair by the same surgeon between 2003 and 2008. The evaluated items were the operating time, number of used anchors, extent of the Bankart lesion. The operating time varied from 55 to 210 minutes and did not decrease with an increase in treated cases. The number of anchors/Bankart lesion was mostly 1 or less in the first 60 cases but 1 or more in most subsequent cases. The operating time/anchor was 9-70 minutes, being 30 minutes or more in the first 50 cases and 20 minutes or less in most subsequent cases. We expected that the total operating time would be reduced with the mastering of the technique. However, the insertion of more anchors may become possible with the learning of the technique even when the extent of the Bankart lesion is the same. Therefore, the operating time/anchor was evaluated, and the following criteria for proficiency were suggested: 1) surgery in 50 cases or more, 2) an operating time of less than 20 minutes/anchor suture. 3) more than 1 anchor /Bankart region "1 hour".
2009-07-27