采用肱二头肌长头移位和Bankart修复的动态前肩稳定可改善亚临界骨丢失患者的临床疗效：一项系统综述

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI:10.1016/j.asmr.2025.101141

Neil Jain M.D. , Jonathan McKeeman M.D., M.B.A. , Margaret Higgins M.D. , Alexander Johnson M.D. , Tyler Smith D.O. , Brian Waterman M.D.

{"title":"采用肱二头肌长头移位和Bankart修复的动态前肩稳定可改善亚临界骨丢失患者的临床疗效：一项系统综述","authors":"Neil Jain M.D. , Jonathan McKeeman M.D., M.B.A. , Margaret Higgins M.D. , Alexander Johnson M.D. , Tyler Smith D.O. , Brian Waterman M.D.","doi":"10.1016/j.asmr.2025.101141","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the clinical outcomes of dynamic anterior stabilization using a long head of the biceps transfer (DAS-LHB) with Bankart repair for management of anterior shoulder instability with subcritical glenoid bone loss.</div></div><div><h3>Methods</h3><div>Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the PubMed, Scopus, EMBASE, and Medline databases was performed in March 2025. Studies were limited to those reporting outcomes for patients ≥16 years old with subcritical glenoid bone loss (≤20%) and undergoing primary DAS-LHB with Bankart repair. Articles were assessed for range of motion, patient-reported outcomes, recurrent instability, and reoperation rates. The Methodological Index for Non-Randomized Studies scoring criteria were used for study appraisal. Forest plots were created to visualize mean differences in variables of interest.</div></div><div><h3>Results</h3><div>Among the 4 studies evaluated, 90 patients with mean ages of 23.4 to 31.9 years were included. Average follow-up and bone loss ranged from 24.0 to 41.8 months and 8.0% to 10.5%, respectively. Rowe scores showed improvements ranging from 54.5 to 74.0 points, with 87.9% to 100% of patients meeting minimal clinically important difference thresholds. Changes in forward flexion and external rotation ranged from 3° to 23° and –2.3° to 8.3°, respectively. Four patients (4.4%) experienced a recurrence of dislocation, of whom 2 underwent successful revision with a Latarjet procedure. Of all patients, 90.1% to 100.0% were able to return to sport at any level, while 60.0% to 78.8% returned to their preinjury level of athletic involvement.</div></div><div><h3>Conclusions</h3><div>DAS-LHB in conjunction with Bankart repair preserves motion while showing clinically important functional improvements with low rates of recurrent instability or complication in the short-term postoperative period for patients with symptomatic shoulder instability.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III and IV studies.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 3","pages":"Article 101141"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dynamic Anterior Shoulder Stabilization Using a Long Head of the Biceps Transfer and Bankart Repair Improves Clinical Outcomes in Patients With Subcritical Bone Loss: A Systematic Review\",\"authors\":\"Neil Jain M.D. , Jonathan McKeeman M.D., M.B.A. , Margaret Higgins M.D. , Alexander Johnson M.D. , Tyler Smith D.O. , Brian Waterman M.D.\",\"doi\":\"10.1016/j.asmr.2025.101141\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To assess the clinical outcomes of dynamic anterior stabilization using a long head of the biceps transfer (DAS-LHB) with Bankart repair for management of anterior shoulder instability with subcritical glenoid bone loss.</div></div><div><h3>Methods</h3><div>Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the PubMed, Scopus, EMBASE, and Medline databases was performed in March 2025. Studies were limited to those reporting outcomes for patients ≥16 years old with subcritical glenoid bone loss (≤20%) and undergoing primary DAS-LHB with Bankart repair. Articles were assessed for range of motion, patient-reported outcomes, recurrent instability, and reoperation rates. The Methodological Index for Non-Randomized Studies scoring criteria were used for study appraisal. Forest plots were created to visualize mean differences in variables of interest.</div></div><div><h3>Results</h3><div>Among the 4 studies evaluated, 90 patients with mean ages of 23.4 to 31.9 years were included. Average follow-up and bone loss ranged from 24.0 to 41.8 months and 8.0% to 10.5%, respectively. Rowe scores showed improvements ranging from 54.5 to 74.0 points, with 87.9% to 100% of patients meeting minimal clinically important difference thresholds. Changes in forward flexion and external rotation ranged from 3° to 23° and –2.3° to 8.3°, respectively. Four patients (4.4%) experienced a recurrence of dislocation, of whom 2 underwent successful revision with a Latarjet procedure. Of all patients, 90.1% to 100.0% were able to return to sport at any level, while 60.0% to 78.8% returned to their preinjury level of athletic involvement.</div></div><div><h3>Conclusions</h3><div>DAS-LHB in conjunction with Bankart repair preserves motion while showing clinically important functional improvements with low rates of recurrent instability or complication in the short-term postoperative period for patients with symptomatic shoulder instability.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III and IV studies.</div></div>\",\"PeriodicalId\":34631,\"journal\":{\"name\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"volume\":\"7 3\",\"pages\":\"Article 101141\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666061X25000677\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X25000677","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

目的评价采用肱二头肌长头移位（DAS-LHB）联合Bankart修复治疗肩关节前路失稳伴亚临界盂骨丢失的临床效果。方法采用系统评价和荟萃分析指南的首选报告项目，于2025年3月对PubMed、Scopus、EMBASE和Medline数据库进行综述。研究仅限于报告≥16岁伴有亚临界盂骨丢失（≤20%）并接受初级DAS-LHB伴Bankart修复的患者的结果。评估文章的活动范围、患者报告的结果、复发不稳定和再手术率。采用非随机研究方法学指数评分标准对研究进行评价。创建森林图以可视化感兴趣变量的平均差异。结果4项研究纳入90例患者，平均年龄23.4 ~ 31.9岁。平均随访24.0 ~ 41.8个月，骨质流失8.0% ~ 10.5%。Rowe评分的改善范围从54.5到74.0分，87.9%到100%的患者达到了最小的临床重要差异阈值。前屈和外旋的变化范围分别为3°至23°和-2.3°至8.3°。4例患者（4.4%）脱位复发，其中2例通过Latarjet手术成功翻修。在所有患者中，90.1%至100.0%能够恢复到任何水平的运动，而60.0%至78.8%恢复到损伤前的运动参与水平。结论sdas - lhb联合Bankart修复在保留运动功能的同时显示出临床上重要的功能改善，并且在症状性肩关节不稳定患者术后短期内复发性不稳定或并发症的发生率较低。证据水平：IV级，III级和IV级研究的系统评价。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Dynamic Anterior Shoulder Stabilization Using a Long Head of the Biceps Transfer and Bankart Repair Improves Clinical Outcomes in Patients With Subcritical Bone Loss: A Systematic Review

Purpose

To assess the clinical outcomes of dynamic anterior stabilization using a long head of the biceps transfer (DAS-LHB) with Bankart repair for management of anterior shoulder instability with subcritical glenoid bone loss.

Methods

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a review of the PubMed, Scopus, EMBASE, and Medline databases was performed in March 2025. Studies were limited to those reporting outcomes for patients ≥16 years old with subcritical glenoid bone loss (≤20%) and undergoing primary DAS-LHB with Bankart repair. Articles were assessed for range of motion, patient-reported outcomes, recurrent instability, and reoperation rates. The Methodological Index for Non-Randomized Studies scoring criteria were used for study appraisal. Forest plots were created to visualize mean differences in variables of interest.

Results

Among the 4 studies evaluated, 90 patients with mean ages of 23.4 to 31.9 years were included. Average follow-up and bone loss ranged from 24.0 to 41.8 months and 8.0% to 10.5%, respectively. Rowe scores showed improvements ranging from 54.5 to 74.0 points, with 87.9% to 100% of patients meeting minimal clinically important difference thresholds. Changes in forward flexion and external rotation ranged from 3° to 23° and –2.3° to 8.3°, respectively. Four patients (4.4%) experienced a recurrence of dislocation, of whom 2 underwent successful revision with a Latarjet procedure. Of all patients, 90.1% to 100.0% were able to return to sport at any level, while 60.0% to 78.8% returned to their preinjury level of athletic involvement.

Conclusions

DAS-LHB in conjunction with Bankart repair preserves motion while showing clinically important functional improvements with low rates of recurrent instability or complication in the short-term postoperative period for patients with symptomatic shoulder instability.