Operative Management of Anterior
Glenohumeral Instability |
| |
Authors: | Markus Wambacher Vinzenz Smekal Christian Dallapozza Dagmar Fritz and Franz Kralinger |
| |
Institution: | (1) Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck (MUI), Innsbruck, Austria;(2) Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck (MUI), Anichstr. 35, 6020 Innsbruck, Austria |
| |
Abstract: | Abstract
Introduction: Management of glenohumeral instability
focuses more on operative treatment, while non-operative
management, especially in young, active patients,
may cause recurrent instability in a high percentage.
Aim: Management of anterior glenohumeral instability,
their advantages and limitations, the operative techniques
and results will be described and discussed.
Materials and Methods: A total of 379 patients who
were operated between 1985 and 1994 for recurrent
shoulder instability were followed up; 110 patients were
managed with open Bankart procedure, 165 patients
with arthroscopic Bankart and 98 patients were treated
with a bone-block procedure. Follow-up evaluation
was performed 53 months on average postoperatively.
According to Rowe the functional results were classified
as excellent and good in 91% with the open Bankart
procedure, 80.6% with the arthroscopic Bankart
repair and the results using the bone-block were rated
as excellent and good in 95.4%. Overall complication
rate was 16.3% (arthroscopic), 6.4% (open Bankart) and
4.4% (bone-block group). In patients with long-time
results, degenerative signs at the glenoid and/or the
humeral head were evaluated on plane radiographs
(according to Rosenberg). In 17 long-term results of the
bone-block procedure, Stage I osteoarthritis was identified
in 25.5%, but no severe osteoarthrosis (stage II or
III), while in the open Bankart group an osteoarthrosis
rate of 18.6% (stages II and III) was found.
Conclusion: Different types and causes of glenohumeral
instability recommend different techniques for operative
treatment of anterior glenohumeral instability.
The bone-block procedure provided the best results
regarding stability and function; long-term radiological
results indicate that bony repair prevents and does not
cause osteoarthrosis. |
| |
Keywords: | Anterior glenohumeral instability Arthroscopy Bankart procedure Bone-block procedure |
本文献已被 SpringerLink 等数据库收录! |
|