ARTHROSCOPIC VERSUS OPEN BANKART PROCEDURES - A COMPARISON OF EARLY MORBIDITY AND COMPLICATIONS

被引:146
作者
GREEN, MR
CHRISTENSEN, KP
机构
[1] Division of Orthopaedic Surgery, Tripler Army Medical Center, Hawaii
来源
ARTHROSCOPY | 1993年 / 9卷 / 04期
关键词
ARTHROSCOPIC BANKART; SHOULDER; ARTHROSCOPIC ADVANTAGES; SURGERY MORBIDITY; GLENOID LABRUM; POSTSURGICAL FUNCTION;
D O I
10.1016/S0749-8063(05)80308-1
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
Morgan recently reported excellent results by arthroscopically suturing detached labra to the glenoid via drill holes in anterior shoulder dislocators. We attempted to quantitatively compare the operative time, and perioperative morbidity employing this technique to these same parameters using the open Bankart procedure. We retrospectively reviewed the records of consecutive patients undergoing either of these procedures at our institution over the past 2 years. Only those cases wherein the labra were reattached to the glenoid via drill holes were considered. There were 20 patients in the arthroscopic and 18 in the open Bankart groups. Using the arthroscopic method, there was a 1.8-fold decrease in operative time. a 10-fold decrease in blood loss, and a 2.5-fold decrease in postoperative narcotic use compared with the open procedure (p < 0.001). Postoperative fevers were similarly reduced. Hospital stay averaged 3.1 days with the open procedure compared with 1.1 days with the arthroscopic method (p < 0.001). Most arthroscopic Bankarts are now performed on a same-day basis. Time lost from work was 25.5 and 15.3 days for the open and arthroscopic procedures, respectively (p < 0.001). There were three complications among the patients treated with the open technique compared with none in the arthroscopic group. Thus, we conclude that the arthroscopic Bankart procedure offers significant improvements in operative time, perioperative morbidity, and complications compared with the open technique for patients with anterior shoulder instability.
引用
收藏
页码:371 / 374
页数:4
相关论文
共 22 条
[1]  
Morgan CD, Bodenstab AB, Arthroscopic Bankart suture repair: technique and early results, Arthroscopy, 3, pp. 111-122, (1987)
[2]  
Turkel SJ, Panio SW, Marshall JL, Et al., Stabilizing mechanism preventing anterior dislocation of the glenohumeral joint, J Bone Joint Surg [Am], 63, pp. 1208-1217, (1981)
[3]  
DePalma AF, Coker AJ, Probhaker M, The role of the subscapularis in recurrent anterior dislocation of the shoulder, Clin Orthop, 54, (1969)
[4]  
DuToit GT, Roux D, Recurrent dislocation of the shoulder, a 24 year study of the Johannesburg stapling procedure, J Bone Joint Surg [Am], 38, pp. 1-12, (1956)
[5]  
Matthews LS, Terry G, Vetter WL, Shoulder anatomy for the arthroscopist, Arthroscopy, 1, pp. 83-91, (1985)
[6]  
Matthews LS, Helfet DL, Spearman J, Et al., Arthroscopy staple capsulorrhaphy for recurrent anterior shoulder instability, Arthroscopy, 4, pp. 106-111, (1988)
[7]  
Mosely HG, Overgaard B, The anterior capsular mechanism in recurrent anterior dislocation of the shoulder. Morphological and clinical studies with special reference to the glenoid labrum and the gleno-humeral ligaments, J Bone Joint Surg [Br], 44, pp. 913-927, (1962)
[8]  
Pappas AM, Gross TP, Kleinman PK, Symptomatic shoulder instability due to lesions of the glenoid labrum, Am J Sports Med, 11, pp. 279-288, (1983)
[9]  
Zarin B, Rowe CR, Stone JW, Shoulder instability: management of failed reconstructions, Instr Course Lect, 38, pp. 217-230, (1989)
[10]  
Rhee KJ, Ahn SR, Jeeong-Koo L, Arthroscopic capsular suture for anterior instability of the shoulder, Orthopedics, 15, pp. 217-224, (1992)