Arthroscopic rotator cuff repair plus Bankart repair for anterior shoulder dislocations combined with rotator cuff rupture / 中华创伤杂志

ABSTRACT

Objective To investigate the efficacy of arthroscopic rotator cuff repair plus Bankart repair for anterior shoulder dislocations combined with rotator cuff rupture in patients above 40 years old.Methods A retrospective case series study was conducted to analyze the clinical data of 23 patients above 40 years old with anterior dislocation of shoulder joint and rotator cuff tear in Honghui Hospital Affiliated to Medical College of Xi'an Jiaotong University from January 2010 to September 2015.There were 10 males and 13 females,aged 40-71 years [(58.1 ± 10.3) years].All patients underwent arthroscopic rotator cuff repair plus Bankart repair.The visual analogue scale (VAS) was used to evaluate pain,the Oxford shoulder instability score (OSIS) was used to evaluate shoulder stability,and ConstantMurley shoulder score was used to evaluate shoulder function.Meanwhile,the range of motion (ROM) of shoulder joint,complications and subjective efficacy feedbacks from the patients were recorded.Results All patients were followed up for 13-46 months [(24.2 ± 10.1) months].Before operation and at the last follow-up,there was significant decrease in the VAS score [(0.6 ± 0.2) points vs.(3.8 ± 1.2)points] and the mean OSIS score [(19.7 ± 5.5) points vs.(47.1 ± 14.1) points];significant increase was found in the Constant-Murley score [(79.1 ± 10.8) points vs.(36.6 ± 6.4) points],the ROM of ante-flexion [(149.1 ± 22.0) vs.(65.8 ± 14.7)],abduction [(119.4 ± 23.2) ° vs.(69.1 ± 16.7) °] and external rotation [(45.0 ± 11.4) ° vs.(8.9 ± 2.7) °] (all P ＜ 0.05).No significant difference was found in the ROM of internal rotation (P ＞ 0.05).There were no significant differences in the mean VAS score and OSIS score between the affected and unaffected shoulders (P ＞ 0.05),but the former had a significantly lower Constant-Murley score than the latter [(79.1 ± 10.8)points vs.(87.7 ± 9.3) points,P ＜ 0.05].In terms of the comparison of ROM,there was no significant difference in joint ante-flexion and internal rotation (P ＞ 0.05),but the affected shoulder had significantly lower ROM of external rotation and abduction [(45.0 ± 11.4) °and (119.4 ± 23.2) °] than the unaffected one [(55.9 ± 13.8) °and (153.1 ± 23.7)°] (P ＜ 0.05).The excellent-good rate of efficacy based on the subjective feedbacks from patients was 78％.Up to the last follow-up,none of the patients had wound infection or recurrent dislocation.Conclusions Arthroscopic rotator cuff repair plus Bankart repair can significantly relieve the pain,improve joint function and range of motion.Compared with the unaffected shoulder,the affected one had slight loss of function and decreased mobility in abduction and external rotation.