Hill-Sachs Off-track Lesions as Risk Factor for Recurrence of Instability After Arthroscopic Bankart Repair

被引:84
|
作者
Locher, Joel [1 ,2 ]
Wilken, Frauke [2 ]
Beitzel, Knut [2 ]
Buchmann, Stefan [2 ]
Longo, Umile Giuseppe [1 ]
Denaro, Vincenzo [1 ]
Imhoff, Andreas B. [2 ]
机构
[1] Campus Biomed Univ, Dept Orthopaed & Trauma Surg, Rome, Italy
[2] Tech Univ Munich, Dept Orthopaed Sports Med, Klinikum Rechts Isar, Ismaninger St 22, D-81675 Munich, Germany
来源
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY | 2016年 / 32卷 / 10期
关键词
ANTERIOR SHOULDER INSTABILITY; BIPOLAR BONE LOSS; GLENOHUMERAL INSTABILITY; QUANTITATIVE SYNTHESIS; SUTURE ANCHORS; FOLLOW-UP; DISLOCATION; FIXATION; STABILIZATION; MANAGEMENT;
D O I
10.1016/j.arthro.2016.03.005
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To evaluate the effect of "off-track" Hill-Sachs lesions, according to the glenoid track concept, as a risk factor for recurrent instability and need for revision surgery after arthroscopic Bankart repair. Methods: We retrospectively reviewed 254 patients with anteroinferior glenohumeral instability who were managed with an arthroscopic stabilization procedure between 2006 and 2013. Preoperative magnetic resonance imaging and/or computed tomography scans were available for 100 of these patients to calculate the glenoid track and the presence of "on-track" or off-track Hill-Sachs lesions. Recurrence of instability was evaluated at a mean follow-up of 22.4 months. Results: Of 100 patients whose magnetic resonance imaging and/or computed tomography scans were available, 88 had an on-track Hill-Sachs lesion and 12 had an off-track Hill-Sachs lesion. Revision surgery for recurrent instability was performed in 5 patients (6%) with an on-track Hill-Sachs lesion and in 4 patients (33%) with an off-track Hill-Sachs lesion (odds ratio, 8.3; 95% confidence interval, 1.85-37.26; P =.006). Conclusions: An off-track Hill-Sachs lesion is a significant and important risk factor for recurrence of instability and need for revision surgery after arthroscopic Bankart repair when compared with an on-track Hill-Sachs lesion. Level of Evidence: Level IV, prognostic case series.
引用
收藏
页码:1993 / 1999
页数:7
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