Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder - A meta-analysis

被引:123
作者
Freedman, KB
Smith, AP
Romeo, AA
Cole, BJ
Bach, BR
机构
[1] Loyola Univ, Ctr Med, Dept Orthoped Surg & Rehabil, Maywood, IL 60153 USA
[2] Rush Presbyterian St Lukes Med Ctr, Rush Med Coll, Chicago, IL USA
关键词
Bankart; instability; shoulder; arthroscopic; repair;
D O I
10.1177/0363546504265188
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
Background: In published comparative studies, it remains unknown if arthroscopic techniques for performing Bankart repair for anterior shoulder instability equal the success of open repair. Hypothesis: The current literature supports a lower rate of recurrent instability after open Bankart repair compared to arthroscopic repair with bioabsorbable tacks or transglenoid sutures. Study Design: Meta-analysis. Methods: A Medline search identified all randomized controlled trials or cohort studies that directly compared open repair to arthroscopic techniques of Bankart repair for traumatic, unilateral, recurrent anterior instability. Data collected from each study included patient demographics, surgical technique, rehabilitation, outcome, and complications. Results: Six studies met all inclusion criteria. There were 172 patients in the arthroscopic group (90 patients with transglenoid sutures, 77 patients with arthroscopic tacks, and 5 patients with suture anchors) and 156 patients in the open group. The groups were similar in demographic characteristics. When comparing the arthroscopic to the open group, there was a significantly higher rate of recurrent dislocation (12.6% vs 3.4%; P = .01) and total recurrence (recurrent dislocation or subluxation) (20.3% vs 10.3%; P = .01). In addition, there was a higher proportion of patients with an excellent or good postoperative Rowe score in the open group (88%) than in the arthroscopic group (71%) (P = .01). Conclusions: Arthroscopic Bankart repair using transglenoid sutures or bioabsorbable tacks results in a higher rate of recurrence of instability compared to open techniques. Studies comparing open repair to newer arthroscopic techniques using suture anchor fixation and capsular plication are necessary.
引用
收藏
页码:1520 / 1527
页数:8
相关论文
共 65 条
[1]  
Akpinar S, 2000, Bull Hosp Jt Dis, V59, P88
[2]   ARTHROSCOPIC BANKART REPAIR VERSUS NONOPERATIVE TREATMENT FOR ACUTE, INITIAL ANTERIOR SHOULDER DISLOCATIONS [J].
ARCIERO, RA ;
WHEELER, JH ;
RYAN, JB ;
MCBRIDE, JT .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1994, 22 (05) :589-594
[3]   Arthroscopic Bankart repair in a high demand patient population [J].
Bacilla, P ;
Field, LD ;
Savoie, FH .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 1997, 13 (01) :51-60
[4]   The pathology and treatment of recurrent dislocation of the shoulder-joint [J].
Bankart, ASB .
BRITISH JOURNAL OF SURGERY, 1938, 26 (101) :23-29
[5]  
Bhagia SM, 2000, ORTHOPEDICS, V23, P589
[6]   Arthroscopic transglenoid suture repair for initial anterior shoulder dislocation [J].
Boszotta, H ;
Helperstorfer, W .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2000, 16 (05) :462-470
[7]   Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion [J].
Burkhart, SS ;
De Beer, JF .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2000, 16 (07) :677-694
[8]   Comparison of arthroscopic and open anterior shoulder stabilization - A two to six-year follow-up study [J].
Cole, BJ ;
L'Insalata, J ;
Irrgang, J ;
Warner, JJP .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2000, 82A (08) :1108-1114
[9]   ARTHROSCOPIC STAPLE CAPSULORRHAPHY FOR ANTERIOR SHOULDER INSTABILITY [J].
COUGHLIN, L ;
RUBINOVICH, M ;
JOHANSSON, J ;
WHITE, B ;
GREENSPOON, J .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1992, 20 (03) :253-256
[10]  
De Mulder K, 1998, Acta Orthop Belg, V64, P160