• Investigative Magnetic Resonance Imaging
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• 제17권1호
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• pp.26-32
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• 2013

목적: 견관절 전방탈구 후 Bankart 병변이 있었던 환자의 자기공명관절조영술 (MRA)에서 Hill-Sachs (HS) 병변의 유무와 정도를 평가하고, 이를 관절경에서 보인 Bankart 병변의 크기와 탈구 빈도와 비교하고자 하였다. 대상과 방법: 견관절 전방탈구 후 발생한 Bankart 병변의 관절경 수술을 시행 받은 86명의 MRA를 분석하였다. MRA에서 HS 병변의 가장 큰 표면길이와, 관절경에서 보인 Bankart 병변의 크기를 측정하였다. HS 병변 길이와 Bankart 병변 크기, 탈구 빈도 사이의 상관성을 분석하였다. 결과: HS 병변은 78명에서 관찰되었다. HS 병변의 가장 긴 표면길이는 평균 18.8 mm (9.3 - 29.6 mm) 였고, Bankart 병변은 평균 4.25시계구간 크기 (1-6시계구간 크기) 였다. 3명은 단일탈구, 75명은 재발탈구였다. HS 병변의 크기는 Bankart 병변의 크기와 유의한 양의 상관관계를 보였고 (p = 0.001, r = 0.37), 탈구 빈도와는 관련성이 없었다. 결론: HS 병변은 Bankart 병변이 있는 환자에서 흔하게 발견되었다. HS 병변과 Bankart 병변의 크기와 유의한 양의 상관관계를 보였다.

• Clinics in Shoulder and Elbow
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• 제18권3호
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• pp.144-151
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• 2015

Background: The consensus is that a bony Bankart lesion shorter than 25% of the length of glenoid does not affect the clinical result; hence, such lesions were often neglected. However, small bony Bankart lesions are associated with various types of capsulolabral lesions. Methods: A total of 82 patients who had undergone arthroscopic capsulolabral lesion repair surgery for anterior shoulder dislocation were reviewed. The prevalence rates of early and late type of capsulolabral lesions were compared between a group of patients with and a group without small bony Bankart lesions. In addition, the types of accompanying capsulolabral lesion were analyzed according to the type of bony Bankart lesion. Finally, the clinical outcomes were evaluated (active range of motion, American Shoulder and Elbow Surgeons score and Rowe's score). Results: Among the 13 patients who had small bony Bankart lesions, the prevalence rate of early and late type of capsulolabral lesions was 38.5% and 61.5%, respectively. Among the 69 patients without bony Bankart lesion, the prevalence rates of early and late type of capsulolabral lesions were 74% and 26%, respectively. Significantly worse clinical outcome was observed for the group of patients with both small bony Bankart lesions and late type of capsulolabral lesion. Conclusions: More severe type of small bony Bankart lesion appears to be associated with late type of capsulolabral lesion. The significantly worse clinical outcome for patients with both small bony Bankart lesion and late type of capsulolabral lesion indicates that small bony Bankart lesions cannot always be neglected.

• 대한관절경학회지
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• 제9권2호
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• pp.186-193
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• 2005

목적: ALPSA(anterior labroligamentous periosteal sleeve avulsion) 병변과 Bankart 병변을 관절경하에서 구별할 수 있는지를 알아보고자 하였으며 ALPSA 병변의 임상적 의의를 알아보고자 하였다. 대상 및 방법: 견관절의 전방 불안정성으로 관절경하에서 Bankart 복원술을 시행한 66예를 대상으로 하였다. 자기 공명 영상의 판독상 Bankart 병변은 56예(85%) ALPSA 병변은 10예(15%)였다. 각 병변의 관절경 소견을 분류하였으며 결과는 평균 22개월 추시하였다. 결과: Bankart 병변 보다 ALPSA 병변의 발생 시기가 보다 젊은 층에서 발생하였다 관절경하에서 ALPSA 병변은 여러 형태를 보였으며 특히 하내측으로 많은 전위를 보인 경우가 5예에서 관찰되었다. Bankart 병변도 심한 전위를 보인 경우가 21예였으며 견갑 경부로부터 뚜렷하게 외측 전위되지 않고 하내측으로 전위된 경우는 관절경하에서 ALPSA 병변과 구별하기 어려웠다. 재발은 ALPSA 군에서는 재탈구는 없었으나 불안감이 2예(20%)에서 있었고 하내측으로 많은 전위를 보인 예에서 나타났으며, Bankart 군에서는 재탈구 1예, 아탈구 1예, 불안감 2예로 총 4예(7.1%)에서 있었다. 결론: 하내측으로 심하게 전위된 Bankart 병변과 ALPSA 병변은 식별이 용이하지 않았으며 전위가 심한 ALPSA 병변에서 재발율이 높았다. 따라서 복원술시 ALPSA 병변을 철저하게 재분리하는데 보다 주의가 요할 것으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제21권1호
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• pp.37-41
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• 2018

Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

• 대한관절경학회지
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• 제12권2호
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• pp.134-138
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• 2008

견관절 상완순 전후방(SLAP: Superior labrum anterior to posterior) 병변은 상부 관절와순 단독 손상으로 발견되기도 하고, 견관절 재발성 탈구 환자에서 전하방 관절와순의 파열, 즉 Bankart 병변의 연장으로 상부 관절와순까지 파열이 진행된 동반 손상으로 발생하기도 하며, 드물게 후방 Bankart 병변을 동반하는 경우도 있다. 여러 가지 병변과 동반된 SLAP 병변이 보고되어 왔으나 그 중 후방 Bankart 병변과 동반하여 발생한 후방 II형 SLAP 병변에 대한 보고는 미미하고 그 병변에 대한 관절경적 복원술 시 봉합 나사(suture anchor)의 삽입과 봉합에 주의할 점이 있다. 저자들은 투구 동작과 같은 흔한 손상 기전이 아닌 팔을 뻗친 상태에서 넘어지면서 발생한 외상으로 야기된 본 증례에 대해 관절경적 복원술을 시행하여 만족할 만한 결과를 얻었기에 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제20권3호
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• pp.138-146
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• 2017

Background: Arthroscopic fixations for large and comminuted bony Bankart lesions are technically difficult. We developed an arthroscopic multiple pulled suture (MPS) technique to restore large and comminuted bony Bankart lesions. Methods: Ten patients (mean age, 49.8 years; range, 31-79 years) underwent bony Bankart repair using the illustrated MPS technique and were then followed for a mean of 27.3 months. A plain radiograph series and three-dimensional computed tomography scans were taken at the initial clinical evaluation and 3 months postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California at Los Angeles (UCLA) score, and subjective patient satisfaction, along with surgical complications. Results: Union of an osseous fragment with the glenoid rim was confirmed in all patients on a computed tomography scan 3 months after operation. The osseous fragment was restored to proper articular congruence and reduction. The affected shoulder was stable in nine of the 10 patients. One patient presented with a redislocation after a sports injury 3 years postoperatively. The ASES, Rowe, and UCLA scores improved at the final evaluation, and median patient satisfaction at the final follow-up was 9 of 10 points (range, 6-10 points). Conclusions: The arthroscopic MPS technique for bony Bankart lesions with large or comminuted osseous fragments was a relatively easy and safe method for stable fixation of the osseous fragment. Therefore, the arthroscopic MPS technique resulted in good restoration of stability with high patient satisfaction and low complication rates.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.23-30
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• 2005

Purpose: This paper analyzes the results of arthroscopic bankart repair for anterior recurrent dislocation following a trauma on shoulder. Material and Methods: The subjects were twenty-three (23) cases that were available to follow up for more than eighteen months during the period from November 2001 to June 2003 and were chosen from patients to whom arthroscopic bankart repair was applied using a knotless suture anchor for their traumatic anterior recurrent dislocation on the shoulder. Their average age was 28 (ranging from 15 to 60) with 20 males and 3 females. The injury from sports activities accounted for the most cases with 14 subjects. The average follow-up period was 27 months (ranging from 18 months to 35 months). There were 19 cases of bankart lesions, 4 cases of ALPSA lesions and associated with 5 cases of partial tear in the rotator cuff. The anchors employed were knotless anchor (Mitek) for all the cases. Rowe scoring scale was adopted to judge the results after operations. Patients' subjective satisfaction and range of motion of external rotation were addressed together. Results: Rowe scores showed that 20 cases (87%) reaches the level of 'good' and hinger. The average patients' satisfaction accounted for 90 points out of 100. It was also found that external rotations averagely decreased by 6.5 degree when the range of motion was in at the side. Conclusion: There were satisfactory results of arthroscopic bankart repair using knotless suture anchors as an operative treatment for traumatic anterior recurrent dislocation on shoulder.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.22-22
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• 2009

• Clinics in Shoulder and Elbow
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• 제9권1호
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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.

• 대한한의학회지
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• 제40권3호
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• pp.177-187
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• 2019

Objectives: The aim of this study was to report the clinical improvement of a patient who underwent arthroscopic Bankart repair using a rehabilitation protocol involving Korean medicine. Methods: The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy, and Doin exercise therapy during the admission period. To estimate the patient's status, we used the Numeric Rating Scale (NRS), Pain Disability Index (PDI), assessments of the range of motion (ROM) and Muscle Manual Test (MMT) for the shoulder joint. Results: After administering the abovementioned treatments, we found that the patient's NRS, PDI, and ROM and MMT for the shoulder joint were improved. Conclusions: The rehabilitation protocol involving Korean medicine can be applied to and produce good results for patients who undergo arthroscopic repair for Bankart lesions. The limitation of the study was that the number of cases we studied was insufficient to prove the effectiveness. Hence, further studies are needed for designing the rehabilitation protocol involving Korean medicine.