鏡視下 Bankart 修復術におけるアンカー挿入時の骨孔についての検討

概要

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Background: In general, it is difficult to insert an anchor at the inferior part of glenoid in arthroscopic Bankart repair. In addition, the anchor at that part has not been sure to be placed within scapula bone. The purpose of this study was to assess a drill hole of a suture anchor to be made for arthroscopic Bankart repair. Methods: Six consecutive patients, who had recurrent anterior shoulder instability, were included in this study. All the patients underwent surgery with a standardized arthroscopic Bankart technique. Computed tomography (CT) images of the scapula were taken at least one month after surgery. From those data, 3-D scapula models were created by using the software, Mimics and Magics (Materialize, Belgium). Moreover, the distances between the edge of the drill hole of an anchor and the surface of glenoid rim were measured at 3, 6, 9, 12, 15 and 18mm depth from the entering point (0mm) on the 3-D fields. Results: The mean age at surgery was 25.4 years old (range 17 to 40). A total of 27 drill holes (14 holes at anterosuperior: 0 ∼ 90°, 11 holes at anteroinferior: 90 ∼ 180°, 2 holes at posteroinfrior: 180 ∼ 210°) were investigated on this study. The two holes at posteroinferior position have not been fully surrounded with glenoid bone. Conclusion: From the above results, the drill hole should be created carefully in the inferior area, especially around the 6 o'clock position.