格闘技選手の反復性肩関節前方不安定症に対する鏡視下手術成績

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Background: The purpose of this study was to evaluate clinical outcome of arthroscopic Bankart repair in martial arts players. Methods: Subjects consisted of 57 martial arts players who underwent arthroscopic stabilization for recurrent anterior glenohumeral instability between 2004 and 2010. These included 49 males and 8 females with a mean age of 24.5 years old. Among them were, 15 karate players, 10 wrestlers, 10 mixed-martial-arts players, 8 boxers, 7 kick boxers, 2 kendo players, 2 aikido players and 3 others were included. Arthroscopic Bankart repair is performed using 4 suture anchors between 2 and 6 o'clock on the face of the glenoid. Rotator interval closure was utilized depending on the patients risk factors which included the bone morphologies, age, joint laxity and sports activity. The causes of first time dislocation, details of surgery and clinical outcomes were reviewed retrospectively. Results: The first time dislocation occurred in 44 patients at the time of contact with the opponent. Typical cases of contact were crossing each arm with the opponent when punching and the arm taken by the opponent when grappling. Thirty-six SLAP lesions, 6 capsule tears, 4 rotator cuff tears and one HAGL lesion were addressed in addition to Bankart repair. Rotator interval closure was performed in 52 shoulders. Fifty patients returned to their sports at an average of 7.7 months after surgery. No significant motion loss was evident at the final follow up. Rowe score was significantly improved postoperatively. Conclusion: Three patients experienced re-injury after return to their sports. Arthroscopic stabilization for this high demand population yielded satisfactory outcomes in terms of recurrence and sports return rate.

格闘技選手の反復性肩関節前方不安定症に対する鏡視下手術成績

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