Abstract

Purpose

Capsular volume reduction in the context of anterior arthroscopic shoulder stabilization represents an important but uncontrolled parameter. The aim of this study was to analyse capsular volume reduction by arthroscopic Bankart repair with an individualized capsular shift in patients with and without ligamentous hyperlaxity compared to a control group.

Methods

In the context of a prospective controlled study, intraoperative capsular volume measurements were performed in 32 patients with anterior shoulder instability before and after arthroscopic Bankart repair with an individualized capsular shift. The results were compared to those of a control group of 50 patients without instability. Physiological shoulder joint volumes were calculated and correlated with biometric parameters (sex, age, height, weight and BMI).

Results

Patients with anterior shoulder instability showed a mean preinterventional capsular volume of 35.6 ± 10.6 mL, which was found to be significantly reduced to 19.3 ± 5.4 mL following arthroscopic Bankart repair with an individualized capsular shift (relative capsular volume reduction: 45.9 ± 21.9%; P < 0.01). Pre-interventional volumes were significantly greater in hyperlax than in non-hyperlax patients, while post-interventional volumes did not differ significantly. The average shoulder joint volume of the control group was 21.1 ± 7.0 mL, which was significantly correlated with sex, height and weight (P < 0.01). Postinterventional capsular volumes did not significantly differ from those of the controls (n.s.).

Conclusion

Arthroscopic Bankart repair with an individualized capsular shift enabled the restoration of physiological capsular volume conditions in hyperlax and non-hyperlax patients with anterior shoulder instability. Current findings allow for individual adjustment and intraoperative control of capsular volume reduction to avoid over- or under correction of the shoulder joint volume. Future clinical studies should evaluate, whether individualized approaches to arthroscopic shoulder stabilization are associated with superior clinical outcome.

中文翻译：

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具有个性化关节囊移位的关节镜 Bankart 修复术可恢复肩关节前不稳定患者的生理性关节囊体积

摘要

目的

在前关节镜肩稳定的背景下，囊体积减少是一个重要但不受控制的参数。本研究的目的是分析与对照组相比，有或没有韧带过度松弛的患者通过关节镜 Bankart 修复术进行的关节囊体积减少，并进行个性化的关节囊移位。

方法

在一项前瞻性对照研究的背景下，对 32 名肩关节前部不稳定患者在进行个性化关节囊移位的关节镜 Bankart 修复前后进行了术中关节囊容积测量。将结果与没有不稳定的 50 名患者的对照组进行比较。生理性肩关节体积被计算并与生物特征参数（性别、年龄、身高、体重和 BMI）相关联。

结果

肩关节前部不稳定患者的平均介入前关节囊体积为 35.6 ± 10.6 mL，发现在关节镜 Bankart 修复和个性化关节囊移位后显着减少至 19.3 ± 5.4 mL（相对关节囊体积减少：45.9 ± 21.9%；P  < 0.01)。过度松弛患者的干预前体积显着大于非过度松弛患者，而干预后体积没有显着差异。对照组平均肩关节体积为21.1±7.0 mL，与性别、身高、体重显着相关（P  < 0.01）。介入后囊体积与对照组 (ns) 没有显着差异。

结论

具有个性化关节囊移位的关节镜 Bankart 修复能够恢复肩关节前部不稳定的过度松弛和非过度松弛患者的生理性关节囊体积状况。目前的研究结果允许个体调整和术中控制关节囊体积的减少，以避免肩关节体积的过度矫正或矫正不足。未来的临床研究应评估关节镜下肩部稳定的个体化方法是否与优异的临床结果相关。