脱臼
サルベージ手術としての鏡視下 Bankart 修復術
- 外傷性肩関節前方不安定症に対する直視下手術後再脱臼例の検討 -
- 外傷性肩関節前方不安定症に対する直視下手術後再脱臼例の検討 -
2009 年 33 巻 3 号 p. 667-670
詳細
2009 年 33 巻 3 号 p. 667-670
The purpose of this study was to analyze the results of arthroscopic revision Bankart repair after initial open surgeries. We retrospectively reviewed 9 shoulders in 9 patients with failed open reconstruction surgeries for traumatic recurrent anterior glenohumeral instability of the shoulder, who were treated by arthroscopic revision Bankart repair for the patients, from 2002 to 2008. The average age at initial surgery was 28(18-38) years old. The initial surgical procedures were, Putti Platt in 1, shoulder, Boytchev in 1, Modified Oudard-Iwahara-Yamamoto in 1, inferior capsular shift in 1, Bankart-Bristow in 1, Bristow in 1 and open Bankart repair in 3. The average follow-up period was 19.7 (12-36) months. We analyzed the arthroscopic findings and clinical results using Rowe's score and JSS shoulder instability score. The arthroscopic findings of revision Bankart repair were a detached anterior labrum in all 9 shoulders (100%). Arthroscopic revision Bankart repair was performed for all cases, using 3 or 4 absorbable suture anchors. 4 anchors were used in 7 shoulders, and 3 anchors were used in 2 shoulders. No patients had recurrence after revision surgeries. Postoperative average JSS shoulder instability score was 90.9 points and average Rowe score was 96.1 points. Rowe grading was excellent in all patients. The cases after the initial surgical procedure which was not invasive to the joint (modified Oudard-Iwahara-Yamamoto, modified Bristow, Boytchev procedure) could be repaired easily as well as initial arthroscopic Bankart repair. Another case after the initial surgical procedure which was invasive to the joint were required a variety of resources. Procedural considerations included limited mobility due to adhesion of the anterior articular capsule and interference with the previously inserted metal anchor. Arthroscopic Bankart repair is useful as a revision surgery for the failed reconstruction for the traumatic recurrent anterior glenohumeral instability of the shoulder.
