关节镜下Bankart修复术的临床疗效及术后复发危险因素

发布时间：2019-03-21 11:43

【摘要】：目的:探讨关节镜下Bankart修复术治疗肩关节前向不稳的中长期疗效,并分析术后复发的危险因素。方法:对2012年3月至2016年3月收治的115例行关节镜下Bankart修复术的肩关节前向不稳患者进行回顾性研究;其中男81例,女34例,年龄16~70(29.1±8.2)岁。随访采用Constant-Murley评分、Rowe评分及美国肩肘外科学会(ASES)评分评估手术疗效。采用logistic回归分析术后肩关节不稳复发的危险因素。结果:115例患者术后随访12~60个月;末次随访Constant-Murley评分、ASES评分及Rowe评分均较术前提高(P0.001)。13例术后复发,总体复发率为11.3%;logistic回归分析显示:手术时年龄≤20岁、参加过顶或对抗性运动、肩胛盂骨缺损是关节镜下Bankart修复术术后复发的独立危险因素,其OR(95%CI)分别为4.786(1.035~22.125)、9.481(1.791~50.202)、4.500(1.053~19.229)。结论:关节镜下Bankart修复术治疗复发性肩关节前向不稳临床疗效满意;手术时年龄≤20岁、参加过顶或对抗性运动、肩胛盂骨缺损是术后复发的危险因素。
[Abstract]:Objective: to investigate the long-term efficacy of arthroscopic Bankart repair in the treatment of anterior instability of shoulder joint and to analyze the risk factors of postoperative recurrence. Methods: from March 2012 to March 2016, a retrospective study was conducted in 115 patients with anterior shoulder instability who underwent arthroscopic Bankart repair, including 81 males and 34 females, aged 16-70 (29.1 卤8.2) years. Constant-Murley score, Rowe score and (ASES) score of the American Society of shoulder and elbow surgery were used to evaluate the curative effect of the operation. The risk factors of postoperative shoulder instability were analyzed by logistic regression. Results: the Constant-Murley score, ASES score and Rowe score were improved in the last follow-up of 12 months and 60 months after operation (P0.001), 13 cases recurred after operation, the overall recurrence rate was 11.3%, and the total recurrence rate was 11.3% after the last follow-up (P0.001). Logistic regression analysis showed that the age of operation was less than 20 years old and participated in overtopping or antagonistic exercise. Scapular glenoid defect was an independent risk factor for recurrence after arthroscopic Bankart repair, and its OR (95%CI) was 4.786 (1.035 卤22.125), respectively. 9.481 (1.791-50.202), 4.500 (1.053-19.229). Conclusion: arthroscopic Bankart repair is effective in the treatment of recurrent anterior shoulder instability, the age of operation is less than 20 years, taking part in overtopping or antagonistic exercise and scapular glenoid defect are the risk factors for postoperative recurrence.
【作者单位】：上海交通大学附属第六人民医院骨科;
【分类号】：R687.4

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