关节镜下双排固定技术治疗中度骨性Bankart损伤的临床研究OA

Objective To evaluate the clinical effectiveness of the arthroscopic double-row suture fixation technique in managing Type II bony Bankart injuries.Methods A retrospective analysis was conducted on 68 patients diagnosed with bony Bankart lesions who underwent arthroscopic repair between January 2017 and December 2021 at Cangzhou Central Hospital.Based on the intraoperative suture fixation method,patients were divided into a double-row suture group(n=35)and a single-row suture fixation group(n=33).The number of anchor screws implanted during surgery and the duration of the procedure were recorded for both groups.Shoulder joint function was evaluated preoperatively,at 1 year postoperatively,and at the final follow-up using the American Shoulder and Elbow Surgeons Score(ASES)and the Constant-Murley Score.Furthermore,all patients underwent tomography(CT)and magnetic resonance imaging(MRI)to assess the reduction of Bankart fractures and tendon integrity.Results All patients were followed up with a median follow-up time of 39.5(36,46)months.The number of suture anchors used was significantly higher in the double-row group than in the single-row group(P<0.05),while no significant difference was found in operative time(P>0.05).There were no significant differences in ASES and Constant scores between the two groups preoperatively or at 1 year postoperatively(P>0.05).However,at the final follow-up,the double-row group showed significantly better ASES and Constant scores compared to the single-row group(P<0.05).According to postoperative CT assessment,the excellent-good reduction rate was significantly higher in the double-row group(71.4%)than in the single-row group(42.4%)(P<0.05).Recurrent instability occurred in 4 cases in the double-row group(recurrence rate 11.4%)and in 7 cases in the single-row group(recurrence rate 21.2%),with no statistically significant difference between the groups(P>0.05).Logistic regression analysis indicated that age under 45 years and poor reduction quality were independent risk factors for postoperative instability,with odds ratios(95%CI)of 0.115(0.022-0.606)and 0.137(0.025-0.764),respectively.Conclusion Both single-row and double-row anchor suture fixation techniques yield satisfactory clinical outcomes for the treatment of moderate(Kim type Ⅱ)bony Bankart lesions.However,the double-row fixation technique achieves a higher rate of anatomical reduction and provides better mid-term functional recovery.Age and reduction quality are independent risk factors for postoperative instability.