Objective To evaluate the clinical results of arthroscopic repair of combined Bankart and superior labrum anterior to posterior (SLAP)lesions in patients with recurrent shoulder dislocations.Methods Between May 2011 and January 2015,we reviewed 15 cases with combined Bankart and SLAP lesions with recurrent shoulder dislocations who underwent arthroscopic repair.Their average age during surgery was 24.2 years (ranging from 16 to 38 years).During the operation,we began by repairing the unstable SLAP lesion with absorbable suture anchors before we repaired Bankart lesion from the inferior to superior.Fifteen patients in the control group had isolated Bankart lesions without SLAP lesions and underwent arthroscopic repair.Their mean age was 24.6 years (ranging from 18 to 35 years).The preoperative and postoperative results were analyzed by Visual Analogue Scale (VAS)for pain,the range of motion,American Shoulder and Elbow Surgeon (ASES)and Rowe Shoulder Scores Systems.We compared the results with the isolated Bankart lesion. Results For patients who underwent arthroscopic repair of combined Bankart and SLAP lesions,the mean postoperative follow-up period was 15 months (ranging from 13 to 28 months),vs 22 months (ranging from 21 to 34 months)in the control group.VAS for pain was decreased from preoperative 4.9 to postoperative 1.9 (P <0.05).Mean ASES and Rowe Shoulder Scores were improved from preoperative 56.4 and 33.7 to postoperative 91.8 and 94.1,respectively (P <0.05). Recurrent dislocation was not observed until the last follow-up and anterior instability in two groups was not noted during the physical examination.Compared with the isolated Bankart lesion group,no statistical significance was found in the ASES score,Rowe Shoulder Score,or VAS for pain (P >0.05 ).Anterior flexion,abduction,and internal rotation of the affected shoulder during the last follow-up were normal after surgery.Conclusion For recurrent dislocation of the shoulder with combined Bankart and SLAP lesion,arthroscopic repair using absorbable suture anchors can achieve favorable clinical results.It can effectively restore shoulder function.%目的 考察Bankart合并关节盂上唇从前至后部(superior labrum anterior to posterior,SLAP)损伤的复发性肩关节脱位患者采用关节镜修复手术治疗的临床效果.方法 回顾分析2011年5月至2015年1月间因复发性肩关节脱位接受关节镜下Bankart联合SLAP损伤修复治疗的15例患者临床资料,将其作为试验组研究对象.患者平均年龄为24.2岁(16~38岁).术中首先采用可吸收缝合锚钉对不稳定的SLAP损伤进行修复固定,之后再修复Bankart损伤.另选取15例单纯Bankart损伤接受关节镜修复治疗的复发性肩关节脱位患者作为对照组研究对象,患者的平均年龄为24.6(18~35岁).在术前及末次随访时,采用视觉模拟评分(Visual Analogue Scale,VAS)、美国肩肘关节外科医师评分(American Shoulder and Elbow Surgeons,ASES)、Rowe肩关节评分以及肩关节活动度等对两组患者临床效果进行评估.结果 试验组的平均随访时间为15个月(13~28个月),对照组为22个月(21~34个月).试验组平均VAS评分从术前4.9降低到末次随访时的1.9,差异有统计学意义(P<0.05);平均ASES评分和Rowe肩关节评分分别从术前的33.7和56.4提高到末次随访时91.8和94.1,差异均有统计学意义(P<0.05);在VAS评分、ASES评分以及Rowe评分方面,术前及术后随访时,两组之间差异均无统计学意义(P>0.05).到末次随访时,两组所有病例均未再次出现复发性脱位,经物理检查亦未证实肩关节不稳存在.两组所有病例患侧肩关节的前屈、外展、内旋活动度均恢复至正常水平.结论 关节镜下Bankart联合SLAP损伤可吸收缝合锚钉固定修复治疗复发性肩关节不稳临床效果满意,可有效重建患者肩关节稳定,改善肩关节功能.
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