Arthroscopic Double Endobutton Plate Fixation Of Autologous Iliac Bone In The Treatment Of Bankart Injury With Severe Bone Defects

Background Bankart injury is one of the common causes of anterior shoulder instability.If it is associated with anteroinferior glenoid defect,it is called Bankart injury,which often leads to repeated shoulder dislocation.At present,shoulder glenoid reconstruction is an effective method for the treatment of Bankart injury,of which Latarjet is the most widely used in clinical practice,and iliac bone grafting is also one of the common shoulder glenoid reconstruction procedures,but there are few studies on its postoperative clinical efficacy.Objective To investigate the postoperative clinical efficacy of arthroscopic double Endobutton plate fixation of autologous iliac bone in the treatment of Bankart injury patients with severe bone defects.Methods The clinical data of 21 patients(7 aged≥ 40 years and 14 aged<40 years)with Bankart lesion of the shoulder and severe bone defect who were treated with arthroscopic double Endobutton plate fixation of autologous iliac bone in the Department of Sports Medicine,the Third Affiliated Hospital of Southern Medical University from October 2014 to October 2019 were retrospectively analyzed.The American Shoulder and Elbow Surgeons(ASES)score,Rowe score,and Constant score scale were used to assess shoulder function before surgery and during follow-up,respectively,while active range of motion of the shoulder joint was measured using a goniometer,and the degree of bone defect(preoperative)or bone graft healing and plasticity(postoperative)was observed by shoulder CT.Results All patients(n=21)finished the follow-up,with an average follow-up time of 24 months(20-26 months).None had redislocation or other complications during follow-up.In terms of scale score,the mean ASES score,Rowe score and Constant score were significantly higher during follow-up(P<0.05);in terms of active range of motion,the mean forward flexion elevation and external rotation range of motion were significantly higher during follow-up(P<0.05),and there was no significant difference in the mean internal rotation,internal rotation at 90° of abduction and external rotation range of motion(P>0.05).Radiologically,shoulder CT showed that the average degree of glenoid bone defect was significantly reduced(P<0.05),and the bone graft healed and plastic well.The patients were divided into two groups according to age:the group aged 40 years or older and the group aged less than 40 years.There was no significant difference in the mean ASES score,Rowe score,Constant score and active range of motion of shoulder joint between the two groups at follow-up(P>0.05),but the mean values of each index in the young patient group were better than those in the old group.Conclusion Arthroscopic double Endobutton fixation of autologous iliac bone in the treatment of Bankart injury with severe bone defects had good clinical efficacy,good recovery of shoulder joint function,significantly reduced degree of bone defects,and good healing and plasticity of the bone graft.