Suture anchor法による鏡視下Bankart修復術： 2年以上経過例の成績と術後再発例の検討

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The purpose of this study was to evaluate the minimum 2-year follow-up result of arthroscopic Bankart repair, using suture anchors for traumatic anterior glenohumeral instability. We retrospectively studied 147 shoulders of 140 patients. There were 99 male and 41 female patients. The average age at operation was 23.3 years old (range, 14 to 43). 133 shoulders had recurrent dislocations or subluxations, and 14 shoulders had initial dislocations. The mean interval from the time of the operation to the final follow-up evaluation was 35 months (range, 24 to 116). We performed an additional anterior capsular suture on 12 shoulders, superior labral repairs on 18 shoulders, a rotator interval closure on 22 shoulders, and a thermal capsulorrhaphy on 20 shoulders at the time of their operations. Postoperatively, the average loss of external rotation was 8.2° with the arm at the side, and 5.2° with the arm in 90° of abduction. The Rowes score ranged from 40 to 100 points (average 92.2), and 129 shoulders (87.8%) had a rating of good or excellent at the time of their final follow-up. Postoperatively, 12 shoulders experienced re-dislocation or re-subluxaion, and 13 shoulders demonstrated a mild anterior apprehension sign. Revision surgeries were performed on 7 out of 12 re-injured shoulders. Recurrence of Bankarts lesion with a suture breakage was observed in every shoulder during revision surgery. The factors related to a recurrence are supposed to be a large glenoid bony defect, multidirectional instability, insufficient anterior capsular shift, and poor healing of the anterior capsular mechanism on the anterior glenoid rim cartilage. To obtain a better clinical outcome, careful selection of patients and refinement of repair technique raising initial fixation strength and healing potential are necessary.
日本肩関節学会の論文

Suture anchor法による鏡視下Bankart修復術： 2年以上経過例の成績と術後再発例の検討

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