Knotless suture anchorを用いた関節鏡視下Bankart修復術の手術成績

Surgical Outcome of Arthroscopic Bankart Repair with a Knotless Suture Anchor

　抄録：われわれは2000年1月から，Mitek knotless suture anchorを用いて，鏡視下Bankart修復術を行っている．今回の目的は，術後1年以上経過観察が可能であった29例について報告することである．外傷性反復性肩関節脱臼29例（男性24例，女性5例）に対し本法を施行した．平均年齢は23.6歳（13～47歳）であった．全例apprehension test陽性，relocation test陽性で，Arthro-MRIでBankart lesionを認めた．術後1年経過の時点で，再脱臼は2例であった．術後Roweスコアは平均92.6点であった．外転外旋制限は患健側差で4°であった．本法の利点は縫合が不要なこと，しっかりと固定ができること，関節包のadvancementが容易であるなど単純な方法であることである．

　We have been using the Mitek knotless suture anchor for arthroscopic Bankart repair since January 2000. This report describes our experience in 29 cases followed for 1 year or more after surgery.

　The procedure was used to treat 24 males and 5 females with traumatic recurrent shoulder dislocation or subluxation. The patients' average age was 23.6 years old, and their ages ranged from 13 to 47 years old. All cases were diagnosed on the basis of a positive anterior apprehension test, positive relocation test, and Bankart lesion on arthro-MRI.

　There had been two postoperative dislocations as of 1 year after surgery. The average postoperative Rowe's score of all patients was 92.6. The average loss of external rotation with the arm in abduction was 4 degrees, compared with the other arm.

　The advantages of this device are the simple technique that does not require knotting, the tight fixation, and the easy capsular advancement.