IGHL tensioning 法を用いた鏡視下 Bankart 修復術の短期治療成績

抄録

Background: The purpose of this study is to reveal the minimum 1-year follow up outcome after arthroscopic stabilization for recurrent traumatic anterior instability using IGHL tensioning method.
Methods: Arthroscopic stabilization was performed under the following principles: adequate IGHL tensioning using suture anchors loaded with high strength sutures, which is accomplished by mobilization of labroligamentous complex from 2:00 to 7:30 associated with cartilage resection with 2 to 5mm width at the edge of the glenoid surface from 3:00 to 7:30; repair of associated pathology including capsular and labrum lesions. Between Apr. 2009 and Oct. 2010 we performed index surgery for 59 patients. 5 patients were interviewed by telephone and the rest, 54 patients, were examined at our office.
Results: The average Rowe, UCLA, JSS S-I scores improved significantly from 14.6, 24.4, 51.8 to 97.3, 34.5, 95.2 respectively. Fifty patients (84.7%) had returned to their sports at the preinjury level, six (10.2%) had returned to their sports with minimal restriction, and two had quit his sport for some specific other reason rather than the shoulder. One patient (1.7%) experienced a subluxation. Of the six patients, who could not return to their sports at preinjury level, four had slight ROM limitation of external rotation and two had slight loss of power.
Conclusion: Arthroscopic stabilization with emphasis on IGHL tensioning worked very well. In order to completely return to preinjury level, intensive physical therapy is necessary.