Arthroscopic Stabilization for Recurrent Shoulder Instability With Moderate Glenoid Bone Defect in Patients With Moderate to Low Functional Demand

被引:21
作者
Kim, Sung-Jae [1 ]
Kim, Sung-Hwan [1 ]
Park, Byoung-Kyu [1 ]
Chun, Yong-Min [1 ]
机构
[1] Yonsei Univ, Coll Med, Severance Hosp, Dept Orthopaed Surg,Arthroscopy & Joint Res Inst, Seoul 120752, South Korea
关键词
ANTERIOR GLENOHUMERAL INSTABILITY; CRUCIATE LIGAMENT RECONSTRUCTION; LATARJET PROCEDURE; BANKART REPAIR; DISLOCATION; MANAGEMENT; DEFICIENCY; LAXITY; TEARS; GRAFT;
D O I
10.1016/j.arthro.2014.03.023
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: The purpose of this study was to investigate the functional outcomes of arthroscopic Bankart repair for recurrent shoulder instability in the setting of moderate glenoid bone defect ranging from 20% to 30% in patients with moderate to low functional demand. Methods: This study included 36 patients with unilateral recurrent instability and glenoid bone defects of 20% to 30% treated with arthroscopic stabilization. Glenoid bone loss was estimated on the enface view of preoperative 3-dimensional computed tomography. Joint laxity was assessed clinically by use of the Beighton and Horan criteria, and patients were divided into 2 groups based on the presence of excessive joint laxity, group L (n = 13), or absence of excessive joint laxity, group N (n = 23). Functional assessments were performed with the patient-reported activity level; subjective shoulder value; Rowe score; and University of California, Los Angeles shoulder score. Results: The mean glenoid defect size was 25.1% (range, 20% to 29%), and the overall functional outcomes improved significantly after surgery. A return to greater than 90% of the premorbid activity level was reported by 72% of patients (26 of 36 patients), and patient satisfaction was 83% (30 of 36 patients). There was no significant difference in functional outcomes between groups L and N (subjective shoulder value, 85.0% for group L v 88.9% for group N, P = .397; Rowe score, 83.5 for group L v 92.8 for group N, P - .537; and University of California, Los Angeles shoulder score, 32.2 for group L v 31.9 for group N, P = .697). Recurrent instability occurred in 4 patients (11%), 3 patients in group L (3 of 13, 23%) and 1 patient in group N (1 of 23, 4%), but this difference was not statistically significant (P = .125). Conclusions: Arthroscopic stabilization for recurrent shoulder instability in patients with moderate to low functional demand produced satisfactory outcomes despite the presence of moderate glenoid bone defects of 20% to 30%. For patients with excessive joint laxity, however, arthroscopic stabilization may not be reliable, with a recurrence rate of 23%.
引用
收藏
页码:921 / 927
页数:7
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