Predisposing Factors for Recurrent Shoulder Dislocation After Arthroscopic Treatment
Predisposing Factors for Recurrent Shoulder Dislocation After Arthroscopic Treatment
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DOI：
10.2106/jbjs.h.01126
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发表时间：
2009-11-01
影响因子：
5.3
通讯作者：
Paladini, Paolo
中科院分区：
文献类型：
--
作者：
Porcellini, Giuseppe;Campi, Fabrizio;Paladini, Paolo
背景：关节镜下修复肩部前脱位可能会失败。我们假设可以根据临床病史在术前识别出修复后重新脱位风险较高的患者。本研究的目的是确定以社区为基础的、接受单一关节镜技术治疗的创伤性单向不稳患者群体中复发的危险因素。方法：从2000年1月到2003年12月，625例前路单向不稳患者接受了关节镜Bankart技术治疗，其中385例符合纳入研究的标准。收集人口统计数据，并在第 3、6、12、24 和 36 个月时进行临床随访。结果：在 36 个月时，31 名患者 (8.1%) 经历了再脱位；31 名患者 (8.1%) 经历了再脱位；32 名患者 (8.1%) 经历了再脱位。 22 岁及以下患者的这一比例为 13.3%，老年患者的比例为 6.3%。首次脱位时的年龄、男性以及从首次脱位到手术的时间是复发的显着危险因素（p < 0.05）。 结论： 术前可以根据性别、年龄和从首次脱位到手术的时间来识别肩前脱位关节镜修复术后再脱位的可能性更大的患者。
Background: Arthroscopic repair of anterior dislocation of the shoulder can fail. We hypothesized that patients who are at higher risk for redislocation following repair could be recognized preoperatively on the basis of their clinical history. The purpose of the present study was to identify the risk factors for recurrence in a community-based population of patients with traumatic unidirectional instability that was treated with a single arthroscopic technique.Methods: From January 2000 to December 2003, 625 patients with anterior unidirectional instability were managed with an arthroscopic Bankart technique, and 385 met the criteria for inclusion in the study. Demographic data were collected and clinical follow-up was performed at three, six, twelve, twenty-four, and thirty-six months.Results: At thirty-six months, thirty-one patients (8.1%) had experienced a redislocation; the rate was 13.3% among patients who were twenty-two years of age and younger and 6.3% among older patients. Age at the time of the first dislocation, male sex, and the time from the first dislocation until surgery were significant risk factors for recurrence (p < 0.05 for all).Conclusions: Patients who are more likely to have a redislocation following arthroscopic repair of an anterior shoulder dislocation can be identified preoperatively on the basis of sex, age, and the time from the first dislocation to surgery.