- 作者：Alessandro Castagna ; M.D.a ; Giacomo Delle Rose ; M.D.a ; Mario Borroni ; M.D.a ; mario.borroni@gmail.com ; Berenice De Cillis ; M.D.a ; Marco Conti ; M.D.a ; Raffaele Garofalo ; M.D.b ; Duncan Ferguson ; F.R.A.C.S.a ; Nicola Portinaro ; F.R.C.S. ; M.Sc.R.c
- 刊名：Arthroscopy: The Journal of Arthroscopic & Related Surgery
- 出版年：2012
- 出版时间：March, 2012
- 年：2012
- 卷：28
- 期：3
- 页码：309-315
- 全文大小：376 K
Purpose
To investigate the outcome of arthroscopic capsular repair for shoulder instability in an active adolescent population participating in overhead or contact sports.Methods
We identified 67 patients (aged 13 to 18 years) with post-traumatic recurrent shoulder instability for inclusion in the study from our computer database. Of these patients, 65 (96 % ) were available for clinical review. There were 44 male and 21 female patients, with a mean age of 16 years at the time of surgery. All patients participated in overhead or contact sports at a competitive level. Arthroscopic capsulolabral repair was performed after at least 6 months of failed nonoperative treatment. The mean follow-up was 63 months. Shoulder range of motion and functional outcomes were measured preoperatively and postoperatively with Single Assessment Numeric Evaluation (SANE), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores. Furthermore, type of sport, time until surgery, and number of dislocations were analyzed from our database to find any correlation with the recurrence rate.
Results
At final follow-up, the mean SANE score was 87.23 % (range, 30 % to 100 % ) (preoperative mean, 46.15 % [range, 20 % to 50 % ]); the mean Rowe score was 85 (range, 30 to 100) (preoperative mean, 35.9 [range, 30 to 50]); and the mean ASES score was 84.12 (range, 30 to 100) (preoperative mean, 36.92 [range, 30 to 48]). The mean forward flexion and external rotation with the arm at 90¡ã abduction did not change from preoperative values; 81 % of the patients returned to their preinjury level of sport, and the rate of failure was 21 % . The recurrence rate was not related to the postoperative scores (P = .556 for SANE score, P = .753 for Rowe score, and P = .478 for ASES score), the number of preoperative episodes of instability (P = .59), or the time from the first instability episode to the time of surgery (P = .43). There was a statistically significant relation (P = .0021) between recurrence and the type of sport practiced. Recurrence rate was related to the type of sport practiced.
Conclusions
Arthroscopic stabilization is a reasonable surgical option even in an adolescent population performing sports activities. However, it must be emphasized to the patients and their relatives that the recurrence rate that could be expected after an arthroscopic procedure is higher than in the adult population.
Level of Evidence
Level IV, therapeutic case series.