与标准双入口技术相比，使用单前入口的关节镜 Bankart 修复术手术时间更短，临床效果相当

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-12-01 DOI:10.1016/j.asmr.2024.100984

Ali Okan Gazeloglu M.D. , Abdurrahman Yilmaz M.D. , Egemen Turhan M.D. , Filippo Familiari M.D. , Gazi Huri M.D.

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Patients were evaluated for their clinical results using the American Shoulder and Elbow Surgeons score, the Western Ontario Shoulder Instability index, and the Oxford Shoulder Instability Score pre- and postoperatively. The duration of surgery and recurrent instability were recorded. To prevent suture tangling in the modified 1-portal group, 2 techniques were performed: “cannula in cannula” and “cannula in and out.”</div></div><div><h3>Results</h3><div>A total of 42 patients were included in this study, with 20 in the modified 1-portal group and 22 in the 2-portal group. There were no statistically significant differences between the 2 groups in clinical scores obtained after 2 years of surgery (American Shoulder and Elbow Surgeons score, <em>P</em> = .5; Western Ontario Shoulder Instability index, <em>P</em> = .22; and Oxford Shoulder Instability Score, <em>P</em> = .32). 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引用次数: 0

摘要

目的评估改良的1前门静脉Bankart修复术，并将其与2门静脉Bankart修复术在手术时间、功能评分和复发性脱位方面进行比较。方法选取2014 - 2021年行Bankart修复术的患者，将其分为改良1门静脉组和2门静脉组。纳入标准为18岁，复发性肩前脱位伴Bankart病变，至少随访2年。术前和术后采用美国肩关节外科医生评分、西安大略肩关节不稳定指数和牛津肩关节不稳定评分对患者的临床结果进行评估。记录手术时间和复发不稳定。改良1门静脉组为防止缝线缠结，采用“管中管”和“管进管出”两种方法。结果本研究共纳入42例患者，其中改良1门脉组20例，2门脉组22例。两组患者术后2年的临床评分差异无统计学意义(American Shoulder and Elbow Surgeons评分，P = 0.5；Western Ontario肩部不稳定指数，P = 0.22；牛津肩部不稳定评分，P = 0.32)。改良1门静脉组平均手术时间（65.7±15.8）明显短于2门静脉组（81.1±27.2）（P = 0.03）。两组患者复发性不稳定发生率差异无统计学意义（P≥0.999）。结论采用改良的1门静脉前门静脉技术行bankart修复术，手术时间短，临床效果与2门静脉前门静脉技术相似。证据水平：III级，回顾性队列研究。

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Arthroscopic Bankart Repair Using 1 Anterior Portal Has a Shorter Surgical Time and Comparable Clinical Results With the Standard 2-Portal Technique

Purpose

To assess the modified 1 anterior portal Bankart repair and compare it to the 2-portal Bankart repair in terms of surgical time, functional scores, and recurrent dislocation.

Methods

Patients who underwent Bankart repair from 2014 to 2021 were identified and separated into 2 groups: a modified 1 anterior portal group and a 2 anterior portal group. The inclusion criteria were being >18 years old, having a recurrent anterior shoulder dislocation with a Bankart lesion, and having a minimum 2-year follow-up. Patients were evaluated for their clinical results using the American Shoulder and Elbow Surgeons score, the Western Ontario Shoulder Instability index, and the Oxford Shoulder Instability Score pre- and postoperatively. The duration of surgery and recurrent instability were recorded. To prevent suture tangling in the modified 1-portal group, 2 techniques were performed: “cannula in cannula” and “cannula in and out.”

Results

A total of 42 patients were included in this study, with 20 in the modified 1-portal group and 22 in the 2-portal group. There were no statistically significant differences between the 2 groups in clinical scores obtained after 2 years of surgery (American Shoulder and Elbow Surgeons score, P = .5; Western Ontario Shoulder Instability index, P = .22; and Oxford Shoulder Instability Score, P = .32). The average surgical duration in the modified 1-portal group (65.7 ± 15.8) was significantly shorter than the average surgery duration in the 2-portal group (81.1 ± 27.2) (P = .03). There was no statistically significant difference between the 2 groups for recurrent instability (P ≥ .999).

Conclusions

Bankart repair performed through a modified 1 anterior portal technique has a shorter surgical time and similar clinical outcomes as the 2-portal technique.