抄録
[Purpose] We evaluated the anterior dislocations with no Bankart lesions, especially on their intraarticular pathologies, to clarify their pathologies. [Materials and methods] Fifteen shoulders of 14 patients with documented anterior dislocations which were anthroscopically proved to have no mobile Bankart lesions were evaluated. We studied retrospectively according to the systemic arthroscopic evaluation of intraarticular structures such as labrum, glenoid, glenohumeral ligament, Hill-Sachs lesion, rotator cuff, rotator interval and long head of the biceps, including dynamic examination.
[Results and discussion] The arthroscopic findings which seemed to be related to the primary pathologies of no Bankart lesion were listed below.1: Hypoplasia of the anteroinferior labrum.2: Hypoplasia of the MGHL. #3: AIGHL pathologies were divided into two groups including five subgroups. Type A(ten shoulders) included shoulders with a narrow AIGHL. Two of these shoulders had a lax and torn capsule. Type B (five shoulders)included shoulders with a broad but lax AIGHL. Four of these shoulders had capsular tears. Five out of seven capsular tears from both types were located at the humeral side and two tears at the glenoid side. There were taut, good quality but narrow AIGHLs which could not prevent anterior dislocations.4: Cavities of the superior, posterior and inferior capsule were enlarged.5: A large defect of the rotator interval capsule was recognized in some cases. As a secondary lesion, Hill-Sachs lesion was generally vary small or absent and no mobile Bankart lesion was detected but stable labral detachments were recognized in ten shoulders.
[Conclusion] There was not a single essential lesion of no Bankart lesion. Meticulous evaluation should be performed intraoperatively to determine treatments.
