スポーツ選手に発症した外傷性肩関節前方不安定症に対する鏡視下手術の短期治療成績と関節窩骨形態の関係

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The aim of this study was to evaluate short-term follow-up of arthroscopic Bankart repair (ABR) for traumatic anterior shoulder instability, with special emphasis on the bone defect of glenoid and clinical outcome. 25 shoulders that had ABR performed using suture anchor technique and that were able to observe for more than a year postoperatively were investigated. We evaluated them using the Japanese Orthopaedic Association (JOA) score, Constant score, Rowe score, recurrent rate of shoulder dislocation, percentage of the glenoid rim defect (Itoi et. al.), glenoid rim morphology and postoperative shoulder ROM limitation. Statistical analyses were performed concerning the clinical outcomes (pre vs. post-ope and over 21% vs. under 21% defect of glenoid rim) with paired t test and unpaired t test, respectively. Statistical significance was calculated based on a 5% level. The average JOA, Constant and Rowe score improved significantly. There was no significant limitation of postoperative shoulder ROM and recurrence of shoulder dislocation. Glenoid rim morphology: Normal, Erosion, Fragment = 0, 16, 9 shoulders respectively. Percentage of the glenoid rim defect: over 21%, under 21% = 7, 18 shoulders respectively. All patients in the over 21% group were complicated by bone fragment. There was no significant difference in ROM, power, scores between the over 21% and under 21% group. In this study, there was no significant difference between the over 21% group and the under 21% group in the clinical outcomes of the comparison of pre-op with post-op. In the over 21% group, the patients had the complication of separation fracture, so, it was different from pure glenoid defects like erosion defect type (including compression fracture) reported by Itoi and others. Arthoscopic Bankart repair may be applied to a patient with over 21% glenoid defect, only if complicated by separation fracture.

スポーツ選手に発症した外傷性肩関節前方不安定症に対する鏡視下手術の短期治療成績と関節窩骨形態の関係

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