目的:探索肩关节镜下锚钉植入固定治疗肩关节bankart损伤的疗效。方法:采用肩关节镜下锚钉植入治疗复发性肩关节前脱位伴bankart损伤16例,术前均行肩关节X线和MRI检查,按视触动量的顺序检查肩关节,并与健侧对比并评分,确诊后在关节镜下...目的:探索肩关节镜下锚钉植入固定治疗肩关节bankart损伤的疗效。方法:采用肩关节镜下锚钉植入治疗复发性肩关节前脱位伴bankart损伤16例,术前均行肩关节X线和MRI检查,按视触动量的顺序检查肩关节,并与健侧对比并评分,确诊后在关节镜下行相应部位的锚钉固定,术后按肩关节康复指导进行肩关节功能锻炼。手术前后肩关节的评分均参照美国加州洛杉矶大学(University of California at Los Angeles,UCLA)功能评分标准和视觉模拟评分(visual analogue scale,VAS)。结果:全部病例术后随访7～68(中位数25)个月,术后肩关节稳定性良好,未出现肩关节再发脱位,UCLA术前评分20～22(20.8±0.8)分,终末随访29～35(32.9±1.5)分,其中优6例,良10例,术前及随访终末VAS评分分别为2～4(3.3±0.8)和0～1(0.6±0.5)。结论:关节镜下锚钉植入固定治疗肩关节bankart损伤具有损伤小,术后恢复快,疗效确切等优点。展开更多
背景Remplissage手术可显著降低肩关节Bankart损伤合并Hill-Sachs损伤术后脱位复发率。但该术式对肩关节外旋功能的影响尚无统一意见。目的系统评价关节镜下Remplissage手术对肩关节Bankart损伤合并Hill-Sachs损伤患者肩关节外旋功能的...背景Remplissage手术可显著降低肩关节Bankart损伤合并Hill-Sachs损伤术后脱位复发率。但该术式对肩关节外旋功能的影响尚无统一意见。目的系统评价关节镜下Remplissage手术对肩关节Bankart损伤合并Hill-Sachs损伤患者肩关节外旋功能的影响。方法检索知网、万方、维普、PubMed、Embase、Web of Science数据库2008年5月-2019年12月发表的与Remplissage手术相关的中英文文献。根据非随机对照实验方法学评价指标(MINORS)进行文献质量评价,分析Remplissage手术对肩关节外旋功能的影响。结果本研究共纳入文献15篇,其中英文文献10篇(66.7%),中文文献5篇(33.3%),证据等级Ⅲ级文献3篇(20%),Ⅳ级文献12篇(80%)。共纳入673例患者(674肩),其中Remplissage+Bankart损伤修复术(B+R)546例(81.1%),单纯Bankart手术(B)127例(18.9%)。Meta结果显示,Remplissage+Bankart(B+R)修复术后,肩关节体侧外旋活动受限平均8.6o(P<0.001),90o外展外旋功能较术前无统计学差异(P=0.054)。Remplissage+Bankart损伤修复术(B+R)与单纯Bankart损伤修复术(B)比较,前者肩关节外旋受限稍重,两者外旋受限相差0.74o,差异无统计学意义(P=0.078)。结论Remplissage+Bankart损伤修复术后肩关节外旋功能部分受限,应根据伤情选择手术适应证。展开更多
目的探讨关节镜下双袢固定自体髂骨修复合并严重骨缺损的Bankart损伤患者肩关节临床功能改善及肩胛盂骨缺损修复情况。方法回顾性分析2015年7月至2018年7月在南方医科大学第三附属医院运动医学科采用关节镜下双袢固定自体髂骨植骨术治疗...目的探讨关节镜下双袢固定自体髂骨修复合并严重骨缺损的Bankart损伤患者肩关节临床功能改善及肩胛盂骨缺损修复情况。方法回顾性分析2015年7月至2018年7月在南方医科大学第三附属医院运动医学科采用关节镜下双袢固定自体髂骨植骨术治疗的17例合并严重骨缺损的Bankart损伤患者。在术前和术后使用美国肩肘外科协会(American shoulder and elbow surgeons,ASES)评分、Constant评分、Rowe评分量表并测量肩关节主动活动度以评估肩关节功能改善情况,在三维CT上评估术后骨缺损修复程度。结果所有17例患者均完成随访,期间未出现感染、创伤性关节炎及再脱位等并发症。术后6个月、12个月、24个月平均ASES评分、Constant评分、Rowe评分均较术前显著增高,差异均具有统计学意义(P<0.05),各评分在术后24个月较术后6个月均显著增高,差异均具有统计学意义(P<0.05)。术后6个月、12个月、24个月平均前屈、体侧内旋活动度均较术前显著增大,差异均具有统计学意义(P<0.05);平均体侧外旋、外展90°时内旋、外展90°时外旋活动度在手术前后差异均无统计学意义(P>0.05)。术后6个月、12个月、24个月时平均肩胛盂骨缺损程度均较术前显著降低,差异均具有统计学意义(P<0.05),术后24个月较术后12个月差异均无统计学意义(P>0.05)。术后24个月CT可见各移植骨块均已与肩胛盂融合。结论关节镜下双袢固定自体髂骨修复合并严重骨缺损的Bankart损伤术后患者肩关节功能改善好,移植骨块骨吸收程度较少、愈合良好,随访期间未观察到肩部术后并发症,该术式治疗合并严重骨缺损的Bankart损伤临床效果良好。展开更多
Background: The purpose of this case series was to retrospectively compare radiological, clinical and functional outcomes and complications of diagnostic arthroscopy with open Latarjet procedures pre- and postoperativ...Background: The purpose of this case series was to retrospectively compare radiological, clinical and functional outcomes and complications of diagnostic arthroscopy with open Latarjet procedures pre- and postoperatively within one year after surgery. Additionally we compared the pathologic findings during diagnostic arthroscopy with the radiological findings in preoperative contrast enhanced CT or MRI scans. Methods: Between 07/2009 and 11/2013 46 cases with unidirectional antero-inferior shoulder instability were enrolled, 4 cases were lost during the follow-up within one year postoperatively. Plain radiographs, contrast enhanced multislice studies, Instability Severity Index, Constant, Duplay and Rowe Scores were obtained preoperatively. Diagnostic arthroscopy was performed in all cases prior to open Latarjet procedure. At one year follow-up Constant, Duplay and Rowe Scores were obtained;position and consolidation of the coracoid transfer were assessed by conventional x-ray studies. Results: At one year follow-up a significant improvement of all scores was recorded (Constant Score 95.8 vs. 86.7;Duplay Score 93.7 vs. 25.2, Rowe Score 98.1 vs. 31.7, (p Conclusion: The Latarjet procedure is a reliable technique with very good clinical outcomes. Diagnostic arthroscopy is a valuable tool to detect HAGL- and IGHL-lesions and to visualize the engaging potential of Hill-Sachs-lesions. An additional arthroscopy may help to indicate a Latarjet procedure and to address concomitant pathologies. Level of evidence: Level IV, case series.展开更多
文摘目的:探索肩关节镜下锚钉植入固定治疗肩关节bankart损伤的疗效。方法:采用肩关节镜下锚钉植入治疗复发性肩关节前脱位伴bankart损伤16例,术前均行肩关节X线和MRI检查,按视触动量的顺序检查肩关节,并与健侧对比并评分,确诊后在关节镜下行相应部位的锚钉固定,术后按肩关节康复指导进行肩关节功能锻炼。手术前后肩关节的评分均参照美国加州洛杉矶大学(University of California at Los Angeles,UCLA)功能评分标准和视觉模拟评分(visual analogue scale,VAS)。结果:全部病例术后随访7～68(中位数25)个月,术后肩关节稳定性良好,未出现肩关节再发脱位,UCLA术前评分20～22(20.8±0.8)分,终末随访29～35(32.9±1.5)分,其中优6例,良10例,术前及随访终末VAS评分分别为2～4(3.3±0.8)和0～1(0.6±0.5)。结论:关节镜下锚钉植入固定治疗肩关节bankart损伤具有损伤小,术后恢复快,疗效确切等优点。
文摘背景Remplissage手术可显著降低肩关节Bankart损伤合并Hill-Sachs损伤术后脱位复发率。但该术式对肩关节外旋功能的影响尚无统一意见。目的系统评价关节镜下Remplissage手术对肩关节Bankart损伤合并Hill-Sachs损伤患者肩关节外旋功能的影响。方法检索知网、万方、维普、PubMed、Embase、Web of Science数据库2008年5月-2019年12月发表的与Remplissage手术相关的中英文文献。根据非随机对照实验方法学评价指标(MINORS)进行文献质量评价,分析Remplissage手术对肩关节外旋功能的影响。结果本研究共纳入文献15篇,其中英文文献10篇(66.7%),中文文献5篇(33.3%),证据等级Ⅲ级文献3篇(20%),Ⅳ级文献12篇(80%)。共纳入673例患者(674肩),其中Remplissage+Bankart损伤修复术(B+R)546例(81.1%),单纯Bankart手术(B)127例(18.9%)。Meta结果显示,Remplissage+Bankart(B+R)修复术后,肩关节体侧外旋活动受限平均8.6o(P<0.001),90o外展外旋功能较术前无统计学差异(P=0.054)。Remplissage+Bankart损伤修复术(B+R)与单纯Bankart损伤修复术(B)比较,前者肩关节外旋受限稍重,两者外旋受限相差0.74o,差异无统计学意义(P=0.078)。结论Remplissage+Bankart损伤修复术后肩关节外旋功能部分受限,应根据伤情选择手术适应证。
文摘目的探讨关节镜下双袢固定自体髂骨修复合并严重骨缺损的Bankart损伤患者肩关节临床功能改善及肩胛盂骨缺损修复情况。方法回顾性分析2015年7月至2018年7月在南方医科大学第三附属医院运动医学科采用关节镜下双袢固定自体髂骨植骨术治疗的17例合并严重骨缺损的Bankart损伤患者。在术前和术后使用美国肩肘外科协会(American shoulder and elbow surgeons,ASES)评分、Constant评分、Rowe评分量表并测量肩关节主动活动度以评估肩关节功能改善情况,在三维CT上评估术后骨缺损修复程度。结果所有17例患者均完成随访,期间未出现感染、创伤性关节炎及再脱位等并发症。术后6个月、12个月、24个月平均ASES评分、Constant评分、Rowe评分均较术前显著增高,差异均具有统计学意义(P<0.05),各评分在术后24个月较术后6个月均显著增高,差异均具有统计学意义(P<0.05)。术后6个月、12个月、24个月平均前屈、体侧内旋活动度均较术前显著增大,差异均具有统计学意义(P<0.05);平均体侧外旋、外展90°时内旋、外展90°时外旋活动度在手术前后差异均无统计学意义(P>0.05)。术后6个月、12个月、24个月时平均肩胛盂骨缺损程度均较术前显著降低,差异均具有统计学意义(P<0.05),术后24个月较术后12个月差异均无统计学意义(P>0.05)。术后24个月CT可见各移植骨块均已与肩胛盂融合。结论关节镜下双袢固定自体髂骨修复合并严重骨缺损的Bankart损伤术后患者肩关节功能改善好,移植骨块骨吸收程度较少、愈合良好,随访期间未观察到肩部术后并发症,该术式治疗合并严重骨缺损的Bankart损伤临床效果良好。
文摘Background: The purpose of this case series was to retrospectively compare radiological, clinical and functional outcomes and complications of diagnostic arthroscopy with open Latarjet procedures pre- and postoperatively within one year after surgery. Additionally we compared the pathologic findings during diagnostic arthroscopy with the radiological findings in preoperative contrast enhanced CT or MRI scans. Methods: Between 07/2009 and 11/2013 46 cases with unidirectional antero-inferior shoulder instability were enrolled, 4 cases were lost during the follow-up within one year postoperatively. Plain radiographs, contrast enhanced multislice studies, Instability Severity Index, Constant, Duplay and Rowe Scores were obtained preoperatively. Diagnostic arthroscopy was performed in all cases prior to open Latarjet procedure. At one year follow-up Constant, Duplay and Rowe Scores were obtained;position and consolidation of the coracoid transfer were assessed by conventional x-ray studies. Results: At one year follow-up a significant improvement of all scores was recorded (Constant Score 95.8 vs. 86.7;Duplay Score 93.7 vs. 25.2, Rowe Score 98.1 vs. 31.7, (p Conclusion: The Latarjet procedure is a reliable technique with very good clinical outcomes. Diagnostic arthroscopy is a valuable tool to detect HAGL- and IGHL-lesions and to visualize the engaging potential of Hill-Sachs-lesions. An additional arthroscopy may help to indicate a Latarjet procedure and to address concomitant pathologies. Level of evidence: Level IV, case series.
