• Title/Summary/Keyword: 외상성 견관절 불안정성

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Arthroscopic Bankart Repair: At Least 5 Years Follow-up (관절경적 Bankart 병변 봉합술: 5년 이상 추시 결과)

  • Heo, Mu-Jung;Kim, Kyung-Taek;Kim, Chul-Hong;Kang, Min-Soo;Kim, Hyeon-Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.83-88
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    • 2009
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using metal suture anchors for treatment of chronic traumatic anterior instability of shoulder joint. Materials and Methods: 85 patients (80 male and 5 female) were included in this study. The average age was 26 (15~52) years old and the period from the first injury to operation was average 20 (6~38) months. All cases had Bankart lesion and 44 cases had Hill-Sachs lesion. The SLAP lesion was associated in 10 cases and 7 cases had partial rotator cuff tear. The average follow-up period was 89 (68~108) months. Results: Preoperative Rowe score was average 29.3 (25~50) and Rowe score improved to 86.8 (40~100), excellent in 28 cases (32.9%) and good in 46 cases (54.1%) at last follow up period and 70 cases (82.4%) had full range of motion of the shoulder. The arthroscopic revision surgery of the shoulder was performed in 3 cases (3.5%) because of postoperative re-dislocation. Conclusion: We concluded that arthroscopic Bankart repair with metal suture anchors is one of the reliable and effective method for recurrent anterior shoulder dislocation with Bankart lesion.

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Outcomes after Arthroscopic Repair of Anterior Shoulder Instability after Metal Anchor to Biodegradable Anchor Fixation (견관절 전방 불안정성에 대한 관절경 치료 결과: 금속 나사못 및 흡수성 나사못 고정의 결과 비교)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Han, Bo-Ram
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.158-164
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    • 2008
  • Purpose: We compared the results of arthroscopic Bankart repair using metal and biodegradable anchor fixation. Materials & Methods: We reviewed 26 patients with anterior shoulder instability treated by arthroscopic Bankart repair from October, 2006, to March, 2007, 15 patients with metal anchors and 11 patients with biodegradable anchors. The average age was 27.4 years old (range: 17~55) and mean follow-up was 14 months (range: 12~17 months). Functional outcome was evaluated using the Korean Shoulder Score for Instability (KSSI), Rowe's Bankart Grading scale (RBGS), ASES score, and UCLA scores. Results: In the metal-anchor group, the improvements of mean KSSI, ASES, UCLA score, and RBGS were 20.6, 24.0, 4.0, and 45.5, respectively. In the biodegradable anchor group, improvements of mean KSSI, ASES, UCLA score, and RBGS were 21.0, 23.6, 4.6, and 48.9. The improvements in final outcomes were not significantly different (p>.05). One metal problem and one traumatic redislocation occurred in the metal group. Conclusion: Both techniques produced satisfactory outcomes in the treatment of traumatic anterior instability. The biodegradable anchor group could also avoid problems with metal anchors.

Additional Thermal Shrinkage in Treatment of Recurrent Traumatic Anterior Shoulder Instability (만성 외상성 견관절 전방 불안정성의 치료에서 병행한 관절낭 열 수축술)

  • Kim Seung-Ki;Song In-Soo;Moon Myung-Sang;Lin Guang
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.76-82
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    • 2004
  • Purpose: In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy.

Arthroscopic Bankart Repair in Traumatic Anterior Shoulder Instability with Bio-knotless Anchor (Preliminary and Technical Report) (견관절 외상성 전방 불안정성에 대한 Bio-knotless 봉합 나사못을 이용한 관절경적 Bankart 병변 봉합술 (예비 보고))

  • Yum, Jae-Kwang;Sung, Ki-Hyuk;Shin, Yong-Woon
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.105-110
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    • 2006
  • Purpose: This study reports the clinical results of the arthroscopic Bankart repair in traumatic anterior instability of the shoulder with bio-knotless anchor. Materials and Methods: 21 cases of 21 patients (20 male and 1 female) were included in this study. The average age was 24.8 years old and the period from the first injury to operation was average 37.2 months. All cases had Bankart lesion and 12 cases had Hill-Sachs' lesion. The SLAP lesion was associated in 6 cases. Preoperative Rowe score was average 29.1. Arthroscopic Bankart repair with bio-knotless anchor were performed in all cases; 3 anchors at 3, 4, 5 O'clock position of the glenoid were used in 11 cases and 2 anchors at 4, 5 O'clock position were used in 10 cases. All the associated SLAP lesions were repaired arthroscopically with bio-knotless anchor. Thermal capsular shrinkage at the anterior and inferior shoulder capsule after the Bankart repair was performed in 3 cases. The average follow up period was 20.2 months. Results: The Rowe score improved to 92.8, excellent in 17 cases and good in 4 cases, at last follow up period and 20 cases had full range of motion of the shoulder. 1 case had mild limited range of motion of the shoulder (150 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation) without any problem in normal activity. The arthroscopic revision surgery of the shoulder was performed in 1 case because of multiple traumatic injuries of the shoulder with pain postoperatively. Conclusion: Arthroscopic Bankart repair with bio-knotless anchor in traumatic anterior shoulder instability is one of the good methods because of the good clinical results.

Pectoralis Major Tendon Transfer for Refractory Winged Scapula - A Case Report - (난치성 익상 견갑의 대흉근 이전술 - 증례 보고 -)

  • Ko, Sang-Hun;Cho, Sung-Do;Lee, Ki-Jae;Lee, Chae-Chil
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.236-239
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    • 2009
  • Purpose: We wanted to evalulate the clinical results of pectoris major tendon transfer for a neglected winged scapula that was caused by paralysis of the serratus anterior due to injury to the long thoracic nerve. Materials and Methods: A patient had neglected winged scapula that followed an arthroscopic operation for multi-directional instability of the shoulder joint, which was caused by traumatic dislocation. The patient was treated with pectoralis major tendon transfer using the modified Eden-Lange procedure. The range of a motion was improved from forward flexion $90^{\circ}$ and external rotation $70^{\circ}$ to $170^{\circ}$ and $150^{\circ}$ respectively. Results and Conclusion: There were no complications or recurrence and the patient's psychological satisfaction was also high. If the shoulder girdle muscles are intact, except for the serratus anterior, then pectoralis tendon transfer is a satisfactory method that can provide normal scapulo-thoracic motion.