Results of Arthroscopic Repair of Bankart Lesion in Chronic Anterior Instability of the Shoulder

Halder Rc, Rahaman Sk, K. Mmr, Mamun Mba, Faruqe O, Islam Ms, Hoque M, Rashid Mmo, Hossain Gmj
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Abstract

Background: The shoulder is the most commonly dislocated major joint, affecting roughly 2% of the general population. Long-term studies have demonstrated a correlation between the number of instability episodes and the risk of degenerative arthritis. In an effort to treat the unstable shoulder, orthopedic surgeons have described several different operations that may help to prevent recurrent subluxation or dislocation in chronic instability cases. This study has been undertaken to assess the short-term functional outcome of Arthroscopic repair of Bankart’s Lesion in patients with Chronic Anterior Instability of the Shoulder using Constant Murley’s Score. Material and Method: This prospective observational study was carried out at the National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), from July 2017 to June 2019. Twenty cases of chronic anterior shoulder dislocation meeting the inclusion and exclusion criteria were taken in this study and underwent arthroscopic repair of bankart lesion. Here, 3 or 4 anchors were used. Cases were followed up for 6 months. The outcome was assessed with Constant Murley Scoring. Results: The mean age was 26.716.83 years with a male predominance (95%). Most cases were students (50%) and the main cause of injury was sports (50%). The mean recurrence number was 10.65 ± 4.75 times and was significantly associated with decreasing age. The mean interval between 1 injury and surgery was 3 ± 1.89 years. Bankart lesions were found in 20% of cases in pre-operative imaging. At the final follow-up, 2 (10%) cases of limited movement were found. In 18 (90%) cases, 3 anchors were used. Finally, there was significant improvement regarding pain status, activity of daily living, forward flexion, abduction, external rotation, internal rotation and power of shoulder muscle. In the last follow-up, 2 (10%) cases of limited movement were found. The mean CMS pre-operatively and post-operatively were 63.05 ± 5.23 and 88.25 6.29 respectively (p<0.05). In the final outcome, 16 (80%) scored excellent, 3 (15%) were found good and 1 (5%) was found poor. Conclusion: It may be concluded that arthroscopic Repair of Bankart Lesion with suture anchors in chronic anterior instability of the shoulder is a safe surgery regardless of shoulder function or range of motion.
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肩关节镜下治疗慢性前路不稳的Bankart损伤的结果
背景:肩关节是最常见的主要关节脱位,约占总人口的2%。长期研究表明,不稳定发作的次数与退行性关节炎的风险之间存在相关性。为了治疗不稳定的肩部,骨科医生已经描述了几种不同的手术,这些手术可能有助于预防慢性不稳定病例中复发性半脱位或脱位。本研究采用Constant Murley 's评分评估肩关节镜下慢性前路不稳患者Bankart病变修复的短期功能结果。材料与方法:本前瞻性观察性研究于2017年7月至2019年6月在美国国立创伤与骨科康复研究所(NITOR)进行。本研究选取符合纳入和排除标准的慢性肩关节前脱位20例,行关节镜下bankart病变修复术。在这里,使用了3或4个锚。病例随访6个月。采用Constant Murley评分法评估结果。结果:平均年龄26.716.83岁,男性居多(95%)。以学生为主(50%),运动损伤为主(50%)。平均复发次数为10.65±4.75次,与年龄的降低有显著相关性。1次损伤至手术的平均时间间隔为3±1.89年。术前影像学检查发现20%的病例存在Bankart病变。在最后随访时,发现2例(10%)活动受限。在18例(90%)病例中,使用了3个锚。最后,疼痛状态、日常生活活动、前屈、外展、外旋、内旋和肩部肌肉力量均有显著改善。在最后一次随访中,发现2例(10%)活动受限。术前、术后CMS平均值分别为63.05±5.23、88.25 6.29 (p<0.05)。在最终结果中,优16例(80%),良3例(15%),差1例(5%)。结论:无论肩关节功能或活动范围如何,关节镜下缝合锚钉修复Bankart病变是一种安全的手术。
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