■一个多中心,一项比较孤立Bankart修复术(NOREMP)与Bankart修复术(REMP)的双盲随机对照试验报道,在减少术后2年复发性不稳定方面,应用Romplissage的益处.超过这个时间点的持续好处还有待探索。
■对(1)比较这些先前随机接受Bankart修复术(NOREMP)或Bankart修复术(REMP)的患者的中期(3至9年)结局,以治疗复发性前路肱骨不稳;(2)检查失败率,整体反复出现的不稳定性,和再手术率。
■随机对照试验;证据水平,1.
■原始随机试验的招募和随机化发生在2011年至2017年之间。包括≥14岁的患者,这些患者被诊断为复发性创伤性肩前不稳定,并伴有任何大小的Hill-Sachs缺损。关节盂缺损>15%的患者被排除。在2020年,参与者通过电话联系,并就随后的半脱位情况提出标准化问题,位错,或者在他们学习的肩膀上再次手术。“失败”被定义为再脱位,和“总体复发性不稳定”被描述为再脱位或≥2次半脱位。描述性统计,相对风险,进行了Kaplan-Meier生存曲线分析.
■共有108名参与者被随机分组,其中NOREMP组50例和REMP组52例纳入原始研究的分析.从手术到最后一次随访的平均时间分别为49.3个月和53.8个月。分别。NOREMP组的失败率为22%(11/50),而REMP组为8%(4/52)。NOREMP组总体复发不稳定的发生率为30%(15/50),而REMP组为10%(5/52)。生存曲线明显不同,在这两种情况下都支持REMP。
■用于治疗创伤性复发性肩关节前不稳定伴Hill-Sachs病变和亚临界关节盂骨丢失(<15%),在中期随访(平均4年)时,关节镜下Bankart修复术和replissage术后总复发不稳定性发生率显著低于单纯Bankart修复术.未接受保留的患者比接受伴随保留的患者更早地经历了失败(重新脱位),并且翻修/再手术率更高。
■NCT01324531(ClinicalTrials.gov标识符)。
UNASSIGNED: A multicenter, double-blinded randomized controlled trial comparing isolated Bankart repair (NO REMP) to Bankart repair with remplissage (REMP) reported benefits of remplissage in reducing recurrent instability at 2 years postoperative. The ongoing benefits beyond this time point are yet to be explored.
UNASSIGNED: To (1) compare medium-term (3 to 9 years) outcomes of these previously randomized patients undergoing isolated Bankart repair (NO REMP) or Bankart repair with remplissage (REMP) to manage recurrent anterior glenohumeral instability; (2) examine the failure rate, overall recurrent instability, and reoperation rate.
UNASSIGNED: Randomized controlled trial; Level of evidence, 1.
UNASSIGNED: Recruitment and randomization for the original randomized trial occurred between 2011 and 2017. Patients ≥14 years diagnosed with recurrent traumatic anterior shoulder instability with an engaging Hill-Sachs defect of any size were included. Those with a glenoid defect >15% were excluded. In 2020, participants were contacted by telephone and asked standardized questions regarding ensuing instances of subluxation, dislocation, or reoperation on their study shoulder. \"Failure\" was defined as a redislocation, and \"overall recurrent instability\" was described as a redislocation or ≥2 subluxations. Descriptive statistics, relative risk, and Kaplan-Meier survival curve analyses were performed.
UNASSIGNED: A total of 108 participants were randomized, of whom 50 in the NO REMP group and 52 in the REMP group were included in the analyses in the original study. The mean number of months from surgery to the final follow-up was 49.3 and 53.8 months for the NO REMP and REMP groups, respectively. Failure rates were 22% (11/50) in the NO REMP group versus 8% (4/52) in the REMP group. Rates of overall recurrent instability were 30% (15/50) in the NO REMP group versus 10% (5/52) in the REMP group. Survival curves were significantly different, favoring REMP in both scenarios.
UNASSIGNED: For the treatment of traumatic recurrent anterior shoulder instability with a Hill-Sachs lesion and subcritical glenoid bone loss (<15%), a significantly lower rate of overall postoperative recurrent instability was observed with arthroscopic Bankart repair and remplissage than with isolated Bankart repair at a medium-term follow-up (mean of 4 years). Patients who did not receive a remplissage experienced a failure (redislocated) earlier and had a higher rate of revision/reoperation than those who received a concomitant remplissage.
UNASSIGNED: NCT01324531 (ClinicalTrials.gov identifier).