ABSTRACT
Objective:To explore the short-term effect of arthroscopic posterior suture of the glenoid labial capsule in the treatment of recurrent posterior subluxation (RPS) of shoulder joint.Methods:A retrospective study was conducted on 16 RPS patients who had undergone arthroscopic posterior glenoid capsule folding suture from January 2016 to December 2018, including 12 males and 4 females, with an average age of 22 years (range, 18-37 years). 11 had full-thickness posterior glenoid tear (2 with SLAP injury, 7 with posterior capsular laxity), and 5 had partial posterior glenoid tear (5 with posterior capsular laxity). All 16 patients had active shoulder pain and had undergone arthroscopic posterior glenoid capsule folding suture with suture anchors. After surgery, shoulder abduction was fixed with a sling for 6 weeks to prevent internal rotation of the shoulder; full range of active and passive activities were performed 2-3 months after surgery, and normal movement was resumed 6 months after surgery. Shoulder function was assessed using the American Society of Shoulder and Elbow Surgery (ASES) score and the University of California at Los Angeles (UCLA) end-result score, and shoulder stability was assessed using the instability score in the ASES score.Results:All 16 patients were followed up for 19 months (range, 12-36 months). The shoulder instability score was reduced from 7.6±1.6 preoperatively to 2.0±1.2 postoperatively ( t=5.562, P< 0.001); the ASES score was improved from 45.9±9.8 preoperatively to 85.8±6.1 ( t=39.937, P< 0.001); the pain score was increased from 18.9±5.4 preoperatively to 40.9±4.2 ( t=22.063, P< 0.001); the daily life score was improved from 27.0±7.8 preoperatively to 44.9±3.4 ( t=17.875, P< 0.001), and the UCLA score was improved from 16.1±4.5 preoperatively to 31.9±2.6 ( t=15.813, P< 0.001). One patient had pain during boxing 12 months after surgery, and all patients had significant improvement in shoulder weakness and instability. No patient had instability recurrence. Magnetic resonance showed sutured posterior labrum tearhealed. Conclusion:Arthroscopic posterior glenoid capsule folding suture can repair the labrum injury and restore the tension of the posterior capsule. The glenoid capsule complex healed can increase the posterior obstruction of the scapula. This method can effectively treat RPS with good short-term efficacy.
ABSTRACT
Objective:To investigate the short-term efficacy of hip arthroscopy for different types of femoroacetabular impingement syndrome (FAI).Methods:A retrospective analysis was conducted of the 85 FAI patients who had been treated by hip arthroscopy at Department of Orthopaedic Surgery, General Hospital of Southern Theater Command of PLA from January 2016 to December 2018. They were 52 males and 33 females, aged from 19 to 59 years (average, 36.9 years). According to the anatomical morphology of the acetabulum and proximal femur, there were 26 cases of cam type, 16 cases of pincer type and 43 cases of mixed type. Routine hip arthroscopy was performed to remove the proliferative synovium. Femoral head and neck plasty was conducted for the cases of cam type, resection of the overly covered acetabulum followed by labral suture for those of pincer type, and resection of overly covered acetabulum and labral suture followed by femoral head and neck plasty for those of mixed type. Hip function was assessed one year after surgery using the modified Harris hip score (mHHS), nonarthritic hip score(NAHS), and hip outcome score activity of daily living scale (HOS-ADL); the alpha angle and central edge(CE) angle were measured after CT reconstruction.Results:The 85 patients were successfully followed up for an average of 21 months (range, from 12 to 48 months). The mHHS, NAHS and HOS-ADL for all the patients were improved significantly from preoperative 63.1±7.9, 62.5±7.5 and 62.3±7.9 to 83.4±8.7, 82.9±8.2 and 83.6±8.8 one year after surgery, respectively (all P<0.05) while the mHHS, NAHS and HOS-ADL for the patients of cam, pincer and mixed types were all significantly improved compared to their preoperative values (all P<0.05). The preoperative alpha angles for the cam and mixed types (67.3°±5.2° and 64.2°±5.2°) were significantly reduced to 50.3°±2.9° and 49.6°±2.8° one year postoperatively ( P<0.05); the preoperative CE angles for the pincer and mixed types (52.9°±4.6° and 50.9°±3.6°) were significantly reduced to 33.1°±4.5° and 31.3°±4.3° one year postoperatively ( P<0.05). Conclusion:Hip arthroscopy can effectively treat FAI of cam, pincer and mixed types, leading to good short-term efficacy.