外伤性盂肱关节前方不稳患者关节镜下Bankart损伤修复后后下关节囊紧缩和肩袖间隙闭合（的疗效）—不少于5年的随访

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Arthroscopic posteroinferior capsular plication and rotator interval closure after Bankart repair in patients with traumatic anterior glenohumeral instability—A minimum follow-up of 5 years
外伤性盂肱关节前方不稳患者关节镜下Bankart损伤修复后后下关节囊紧缩和肩袖间隙闭合（的疗效）—不少于5年的随访

Introduction
Surgical repair of a Bankart2 lesion has been considered essential in the treatment of traumatic anterior instability of the shoulder. Although initial experience of arthroscopic techniques evolved for the Bankart repair was disappointing, excellent results of arthroscopic Bankart repair have been reported recently. 10,19,20,23 However, the recurrence rate varied sharply, mainly related to the effect of rotator interval closure, with risk factors of poor capsulolabral tissue, capsular laxity and the types of sports.10,14,25 The residual capsular redundancy and plastic deformation of the capsular ligament have been described as one of the possible causes5 and it had been postulated that Bankart lesion repair alone might not be enough to address the instability.24 Hence, both repair of Bankart lesion and tensioning of the redundant capsule might play a critical role in the restoration of shoulder stability.
引言
手术修复bankart损伤被认为是治疗外伤后肩关节前方不稳所必须的。尽管用关节镜治疗bankart损伤早期不尽人意，但是最近报道了关于关节镜下治疗bankart损伤获得了良好的效果。但是其复发率变化很大，主要与关闭肩袖间隙的效果有关，危险因素有：关节囊盂唇结构不良、关节囊松弛和运动的类型。残留的关节囊冗长和关节囊韧带的塑性变形与复发有关，故而单独的bankart修复不能完全纠正不稳。因此bankart修复和紧缩松弛的关节囊至恢复肩关节稳定性的关键因素
。
The purposeof this study was to evaluate the surgical outcomes of rotator interval closure and posteroinferior capsular plication after arthroscopic stabilisation of anteroinferior capsulolabral lesions for patients with traumatic anterior–inferior shoulder instability.
该研究的目的是评价在关节镜下重建前下关节囊盂唇损伤后，关闭肩袖间隙和紧缩后下关节囊治疗外伤后肩关节前下不稳的术后效果。
Materials and methods
Patient selection/demographics
The approval was obtained from the Institutional Review Board in our institute. From August 2000 to November 2004, patients with traumatic anterior–inferior shoulder instability treated by arthroscopic stabilisation at our institute were retrospectively enrolled. The criteria for inclusion of anterior–inferior shoulder instability consisted of: (1) documented history of traumatic anterior dislocation with>6 months of conservative treatment and (2) preoperative magnetic resonance arthrogram (MRA) with evidence of Bankart lesion. Patients were excluded if they had (1) revision surgery and (2) full-thickness rotator cuff tear. A total of 45 shoulders (45 patients) were enrolled and evaluated retrospectively. Of the 45 shoulders, 27 (60%) occurred during sporting activities, 13 (29%) occurred in traffic accidents and the others resulted from falls. There were 37 male and eight female patients with the average duration of 3.9±2 (0.5–13 years) years from the first episode of dislocation to operation. There were 30 right-sided dislocations and 15 left-sided dislocations. The mean age at the time of the operation was 27 ±9 years (range 16–49 years).
材料和方法
病人选择/病例资料（人口统计资料）
该研究获得了我们医院的学会审查委员会的准许。回顾性地选入了从2000年8月至2004年11月在我们医院治疗的外伤后肩关节前下方不稳的患者45例。肩关节前下方不稳的诊断标准有：（1）既往有外伤性肩关节前脱位并超过6个月保守治疗的病史，（2）术前MRI检查显示有bankart损伤证据。排除标准：（1）有手术修复史，（2）并肩袖的全层撕裂损伤。最终由45例患者（45患肩）入组并做了回归性的评价。在45例患者中，27 (60%)例是在体育运动中损伤，13 (29%)因为车祸，其他的因为摔倒致伤。男性37例，女性8例。从第一次脱位损伤至手术的时间平均为3.9±2 (0.5–13年) 年。30例患肩为右侧，左侧15例。手术时的平均年龄为27 ±9 岁 (16–49 岁)。


Clinical assessment and outcome instruments
Patients’s clinical outcomes were assessed using the University of California at Los Angeles (UCLA) scoring system,12 the Rowe score18 and the American Shoulder and Elbow Surgeons (ASES) score.3 The ROMs of forward elevation, internal rotation and external rotation were measured with the use of a hand-held goniometre. The rotation was measured with the arm in 90° of abduction.
临床评价表和结果测量仪器
患者的临床结果评价标准有：洛杉矶加利福尼亚大学评分系统(UCLA)、Rowe评分表和美国肩肘关节外科医生评分表(ASES)。用便携式测角器评价患肩前举、内旋和外旋的活动度，测量旋转活动度是在上肢外展90°下进行
。
Surgical technique
Under general anaesthetic, the patient was placed in the lateral decubitus position. The arm was placed in padded traction sleeve in 45°of abduction with approximately 10 lb of traction. After sterile preparation, the shoulder joint was first entered and evaluated from the posterior portal. Under arthroscopy, the glenoid bare spot was used for a central reference point to quantify the percentage bone loss of the inferior glenoid.7 The condition of the capsular laxity was evaluated with direct visualisation and palpation with a probe.
手术技巧
在全麻下，患者侧卧位，患肢用牵引袖套住并外展45度以约10磅的力牵引。消毒铺巾后，通过后侧入口进入肩关节并检查关节。在关节镜下，关节盂裸露点用作关节盂下方骨缺损的大小的中心参考点。关节囊的松弛度则通过直接观察和探钩的触诊来评价
。
The details of the arthroscopic technique have been described by many authors.20 Three mini-Revo screws (Linvatec, Largo, FL, USA) loaded with a number 2 Ethibond suture were used for reattachment of anteroinferior capsulolabral complex to the glenoid rim. The tension of the capsule and inferior glenohumeral labraligamentous complex (IGHLC) was then rechecked. Posteroinferior capsular plication was then performed using No. 1
polydioxanone sutures (PDS) (6–7 o’clock for a right shoulder) while maintaining the arm in 45°of abduction and 15°of forward elevation (Fig. 1). This capsular plication was preceded until balance of anterior and posterior capsulolabral structures was reached. The balance was confirmed by both arthroscopic views from anterosuperior portal and intra-operative evaluation.
许多医生都曾描述关节镜下操作的细节，用3枚带2号Ethibond线的 mini-Revo螺丝钉（铆钉？）将前下方关节囊盂唇复合体重新固定在关节盂的边缘。再次检查关节囊和盂肱下盂唇韧带复合体(IGHLC)的张力。在保持上肢外展45度、前举15度下，用1号PDS（聚二恶烷酮缝线）（右肩关节6-7点钟方向）线紧缩后下方关节囊（图1）。紧缩关节囊直至前后关节囊盂唇结构达到了平衡。平衡得经过从前上方入口用镜子查看和术中评估这两项确认。

After posteroinferior plication, an all-inside rotator interval closure between the middle glenohumeral ligament (MGHL) and the superior glenohumeral ligament (SGHL) was performed. The crescent suture hook, loaded with a No. 1 PDS suture, was inserted into the joint superiorly and pierced the SGHL after withdrawing the anterosuperior cannula just above the superior capsule. Another suture retriever was inserted into the joint through the anteroinferior cannula and pierced the MGHL, and then one end of the PDS was grasped and retrieved outside. The other end of the thread was inserted into the joint by knot pusher from the superior cannula and passed outside the joint from the anteroinferior cannula. The rotator interval was closed while maintaining the arm in 40 of abduction and 30of external rotation (Fig. 2).
紧缩后下方关节囊之后，从关节侧缝合位于盂肱上韧带(SGHL)合盂肱中韧带 (MGHL)的间隙即关闭肩袖间隙。用带有1号PDS线的新月形缝合针向上刺入关节，并在后撤位于关节囊上方的前上方套管时，穿过该盂肱上韧带。用另一个缝合针经前下方套管刺入关节，并穿过盂肱下韧带。然后将抓住PDS线的一头牵至外面，而线的另一头则从上方的套管引至前下方的套管，通过推结器打结。关闭肩袖间隙时需保持上肢外展40度和外旋30度（图2）。Postoperative rehabilitation and follow-up
The shoulders were immobilised for 2 weeks with an abduction pillow to maintain the shoulder in 20 of abduction and neutral rotation. During this period, limited passive ROM was allowed. From 3 to 6 weeks, progressive passive forward elevation exercises were initiated. At 6 weeks, active ROM, coordination training and external rotation strengthening exercises were initiated. At 9 weeks, full active ROM with progressively greater resistance exercise was allowed. After 6 months, patients could start throwing activities in sports. Postoperatively, patients were examined monthly during the first 3 months and then at 3 months, 6 months and annually.
术后康复和随访
术后前2周用外展垫使肩关节外展20度，保持中立位固定不动。在这期间，只允许小范围的被动活动。术后3-6周可逐步开始被动前举活动，术后6周起，开始肩关节的主动活动，可进行合作训练外旋加强训练。术后9周后，可逐步进行所有肩关节抗阻力的主动活动，术后6个月后，患者可以参加投掷类的体育活动，术后前3个月每个月复查一次，然后3个月、6个月和1年
。
Statistical analysis
Paired t-test was used to assess the difference between the preoperative and postoperative ROM deficit and shoulder scores (Tables 1 and 2). All analyses were performed with the use of Statistical Analysis System software (version 6.12; SAS, Cary, NC, USA).
统计分析
术前术后的活动范围丢失和肩关节评分通过配对t检验分析其是否有差异（表1和2）所有的统计学分析都是用统计分析系统软件（6.12版本; SAS, Cary, NC, USA)

Results
All patients had completed the functional assessments with the average follow-up period of 77.1 months (ranged 60–111 months). All shoulder scores were improved after the surgery (P < 0.001) (Table 1). A total of 42 shoulders (93.4%) remained completely stable at the final follow-up. According to the Rowe scale, 42 shoulders (93.4%) had an excellent score and three (6.6%) had a poor score. As compared with preoperative ROM, side-to-side difference in forward elevation, external rotation at side or 90 of abduction and internal rotation were not significant (P > 0.05)
(Table 2). There were two patients with side-to-side difference in external rotation of 108. These two patients had ratings of good and excellent results in the Rowe score. The average glenoid bony defect was 17.5% (range 10–30%). Three patients (3/45, 6.6%) had re-dislocations 5–6 months postoperatively. All recurrent dislocation occurred as a result of sports injury. All three cases with recurrences revealed poor results in the UCLA, the ASES and the Rowe scores and they were not satisfied with this operation. One of the three patients received revision arthroscopic repair, while the other two refused. No intra-operative complications, such as iatrogenic neurologic injury, fracture and dislocation, were observed.
结果
所有患者都完成了功能评价，平均随访时间为77.1 个月 (60–111个月)。所有患肩术后都得到了改善(P < 0.001) (表 1)，在最后一次随访时共有42例(93.4%)患肩仍是稳定的。根据Rowe评分表，42例(93.4%)良好，3例(6.6%)差。与术前活动度不同，患肩与健侧在向前上举、外展90度外旋和内旋并无显著性差异(P > 0.05)（表2）。有2例患者患肩与健侧外旋有10度差异。这2例患者的Rowe评分结果为优和良好。关节盂骨缺损的平均大小为17.5% (范围10–30%)。3例患者(6.6%)在术后5-6个月再次脱位，且都是在运动中损伤，他们的UCLA评分、 ASES评分和 Rowe评分均为差，患者本人对手术也不满意，其中有1例再次进行关节镜下修复，另外2例则拒绝。所有患者均无医源性神经损伤、骨折和脱位等术中并发症发生。

Discussion
The principal finding of this study was that in patients with traumatic anterior glenohumeral shoulder instability, arthroscopic stabilisation of anteroinferior capsulolabral structure with rotator interval closure and posteroinferior capsular plication provided a reasonable result at a minimum follow-up of 5 years. Most of these patients can return to their pre-injury activity levels. In addition, no significant loss of shoulder range of motion was found as compared to the healthy side.
本研究最重要的发现是外伤性盂肱关节前方不稳的患者，通过关节镜下关闭肩袖间隙和紧缩后下关节囊稳定前下方关节囊盂唇结构，在不少于5年的随访后获得了良好的效果。大部分患者能恢复到受伤前活动程度。此外与健侧相比，患侧肩关节的活动范围无受限。
In a shoulder with traumatic anterior glenohumeral instability, not only the anterior band of IGHL but also the auxiliary pouch and posterior band of IGHL might show pathological redundancy.8 According to Urayama et al., the anterior band, auxiliary pouch and posterior band served as an anterior stabiliser. Hence, it was recommended that the 6 o’clock position should be firmly repaired during the Bankart procedure.26 In this series, we also added a 6–8 o’clock (right shoulder) plication for posterior band of IGHC to decrease the residual laxity and maintained balance between anterior and posterior capsular shift. Although arthroscopic plication resulted in significantly less volume reduction compared with open capsular shift,9 these additional plication sutures might allow further reduction in volume and a decreased glenohumeral translation.1 Similarly, tightening of the rotator interval decreased the inferior,14 inferior–posterior,14,15 inferior–anterior14 and anterior translation21 of the humeral head; and some authors have emphasised the importance of the rotator interval in instability.13 It has been suggested that the rotator interval capsule contributed to the indirect inferior stability by intraarticular pressure.16 We observed that the rotator interval closure decreased the anterior translation of the humeral head intraoperatively and it might have the protective effect over the anteroinferior capsulolabrum repair. Hence, we believed that both the anteroinferior and posteroinferior laxity should be addressed during the Bankart lesion repair.
在外伤性盂肱关节前方不稳的肩关节中，不仅盂肱下韧带的前束，还有其后束及附属的关节囊都变得松弛。根据Urayama等人的（研究），盂肱下韧带前后束及附属的关节囊是前方的稳定结构，因此建议bankart修复应该主要在6点钟位置。在我们的研究中，还紧缩了盂肱下韧带的后束（右肩为6-8点钟位置），减少残余的松弛部分并凭维持前后关节囊移动的平衡。尽管关节镜下紧缩的部分较切开紧缩的部分少，但是增加的紧缩缝合将减小这种差距，而且减少盂肱关节的移动。同样的，紧缩肩袖间隙将限制肱骨头向下、后下、前下和前方移动。一些医生强调肩袖间隙在肩关节不稳的重要作用，提示肩袖间隙的关节囊通过向关节内的压迫，间接地维持下方稳定。在术中我们注意到关闭肩袖间隙可以限制肱骨头的移动，可能对前下方盂唇修复有保护作用。因此。我们认为在bankart损伤修复中，前下和后下方的松弛都应该处理。
ROM deficit after anteroinferior capsular repair, posteroinferior capsular plication and/or rotator interval closure have been a concern in some series.8,11 In the study of Castagna et al., only a decrease in forward elevation was observed and no rotational deficit was noted. This was probably because that the rotator interval was not tightened.8 Westerheide et al. performed arthroscopic Bankart repair in a series of 71 patients and most of the patients (90%) also received posterior capsular placation; 40% of the patients have decreased ROM after an average follow-up of 33.3 months. However, they did not mention whether the decreased ROM was related to the placation or Bankart repair.27 Meanwhile, some authors noted a full ROM even after Bankart repair and capsular placation.22 A similar result was observed in our study. The reason for difference in ROM results was unclear, but the technique variations and patient’s capsuloligament condition might be the causes. Since capsular laxity was a potential risk factor for recurrence, both posteroinferior capsular plication and rotator interval closure, together with Bankart repair,
were performed in our series. Further, these patients returned to pre-injury activity level without significant ROM limitation as compared with the opposite side.
一些研究中，在前下方关节囊修复、后下关节囊紧缩和/或肩袖间隙关闭常导致肩关节活动范围缩小。在Castagna等人的研究中，只看到了向前上举的范围减小，旋转功能未受影响。这可能是因为肩袖间隙没有紧缩。Westerheide等人关节镜下修复bankart损伤治疗的71例患者，大部分(90%)同样紧缩了后下关节囊，经过33.3个月的随访，40%的患者有肩关节活动范围的减少，但是他们没有指明活动范围的减少是与紧缩有关还是与bankart修复有关。期间，有些研究报道即使在bankart修复和关节囊紧缩后活动范围未见减小，我们的结果与其相同。使活动范围不同的原因未明，但是手术技巧的不同和关节囊韧带条件可能是原因之一。因为关节囊松弛是再发脱位的危险因素，所以我们的研究中在修复bankart损伤的同时紧缩了后下关节囊和肩袖间隙。而且，这些患者回到了受伤前的活动水平，与健侧相比，肩关节活动范围无显著性差异。
Three patients had re-dislocation after 5–6 months of operation. Similar results were noted in other recent arthroscopic Bankart repair, combined with posteroinferior capsular placation studies.8,22,24,27 The definite factors related to our recurrence were still unclear. Poor compliance of patients might be a cause since these three patients returned to previous sports at a relatively early postoperative stage. At the time of revision
surgery, the original repair was detached and residual capsular laxity was noted. Besides, 25%, 30% and 30% of glenoid bony defect was found in these three failed cases, respectively. Further, these three patients had relatively larger defects as compared with the entire patient group (averaged 17.5% defect). It has been observed that a larger glenoid defect could affect surgical outcome of arthroscopic Bankart repair.4,6,17,20 In the series of Kim et al.,20 >30% osseous defect significantly increased the recurrence after repair. According to a cadaveric study of Itoi et al.,17 stability to anteroinferior translation decreased significantly after Bankart repair in the presence of an osseous defect of more than 21% of the glenoid width. Therefore, patients with larger glenoid bony defect may further be predisposed to recurrence.
3例患者在术后5-6个月后再次脱位。其他的一些关节镜下修复bankart损伤合并后下关节囊紧缩也有类似的报道。导致再脱位的确切原因仍未明。医从性差可能是一个原因，因为这3例患者在术后相当早的的阶段就恢复了损伤前的运动，在再次手术时，观察到原来修复的地方已分离，部分残余的关节囊仍松弛。同时这3例患者骨缺损面积分别为25%, 30% 和30%，面积较大的骨缺损将会影响关节镜下bankart修复的效果。在Kim等人的研究中，骨缺损的面积>30%将显著增加修复后的再脱位。通过Itoi等人尸体研究，如果骨缺损超过关节盂横径的21%，bankart损伤修复后，前下的平移稳定性将显著降低。因此，合并有较大骨缺损的患者有再脱位的倾向。
Our study had several limitations, such as a retrospective design and the lack of control patient group. Further follow-up with a larger number of patients is needed. Further, we believed that quantitative measurement of capsular volume reduction after Bankart repair with capsular placation/rotator interval closure is warranted for future study.
我们的研究也有许多局限性，例如回顾性的设计，缺少对照组。而且，需要更大样本量的随访。同时我们相信，定量分析bankart损伤修复合并关节囊紧缩/肩袖间隙闭合使关节囊减少的量将是未来需要研究的。
Conclusions
In our series, with a minimum follow-up of 5 years, most of the patients with traumatic anterior glenohumeral instability gained significant functional improvement after arthroscopic stabilization of anteroinferior capsulolabral structure with rotator interval closure and posteroinferior capsular placation. Further, this procedure would not result in significant loss of shoulder ROM. Therefore, we believed that the suture placation/rotator interval closure is beneficial and should be added as a part of the Bankart repair procedure.
结论
在我们的研究中，大部分外伤性盂肱关节前方不稳的患者，在关节镜下闭合肩袖间隙和紧缩后下关节囊稳定前下方盂唇结构后，进行了不少于5年的随访，均获得了显著地功能改善。同时，没有导致肩关节活动范围有显著意义的减少。因此，我们相信，关节囊紧缩/肩袖间隙闭合是有作用的，而且应该加入到bankart损伤修复的程序中去
。
Conflict of interest statement
The authors declared that there was no conflict of interest.
利益冲突声明
全体作者公然宣明无任何利益冲突
。

References
1. Alberta FG, Elattrache NS, Mihata T, et al. Arthroscopic anteroinferior suture plication resulting in decreased glenohumeral translation and external rotation. Study of a cadaver model. Journal of Bone and Joint Surgery – American Volume 2006;88(1):179–87.
2. Bankart AS, Cantab MC. Recurrent or habitual dislocation of the shoulder-joint. 1923. Clinical Orthopaedics and Related Research 1993;(291):3–6.
3. Barrett WP, Franklin JL, Jackins SE, et al. Total shoulder arthroplasty. Journal of Bone and Joint Surgery – American Volume 1987;69(6):865–72.
4. Baudi P, Righi P, Bolognesi D, et al. How to identify and calculate glenoid bone deficit. Chirurgia Degli Organi di Movimento 2005;90(June (2)):145–52.
5. Bigliani LU, Pollock RG, Soslowsky LJ, et al. Tensile properties of the inferior glenohumeral ligament. Journal of Orthopaedic Research 1992;10(2):187–97.
6. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill–Sachs lesion. Arthroscopy 2000;16(7):677–94.
7. Burkhart SS, De Beer JF, Tehrany AM, Parten PM. Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 2002;18(June (5)):488–91.
8. Castagna A, Borroni M, Delle RG, et al. Effects of posterior–inferior capsular plications in range of motion in arthroscopic anterior Bankart repair: a prospective randomized clinical study. Knee Surgery Sports Traumatology Arthroscopy 2009;17:188–94.
9. Cohen SB, Wiley W, Goradia VK, et al. Anterior capsulorrhaphy: an in vitro comparison of volume reduction – arthroscopic plication versus open capsular shift. Arthroscopy 2005;21(6):659–64.
10. DeBerardino TM, Arciero RA, Taylor DC, Uhorchak JM. Prospective evaluation of arthroscopic stabilization of acute, initial anterior shoulder dislocations in young athletes. Two- to five-year follow-up. American Journal of Sports Medicine 2001;29(October (5)):586–92.
11. Di S, Lo IK, Mohtadi N, et al. Patients undergoing stabilization surgery for recurrent, traumatic anterior shoulder instability commonly have restricted passive external rotation. Journal of Shoulder and Elbow Surgery 2007;16: 255–9.
12. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. End-result study of factors influencing reconstruction. Journal of Bone and Joint Surgery – American Volume 1986;68(8):1136–44.
13. Field LD, Warren RF, O’Brien SJ, et al. Isolated closure of rotator interval defects for shoulder instability. American Journal of Sports Medicine 1995;23(October (5)):557–63.
14. Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior– inferior glenohumeral instability. Two to five-year follow-up [see comment]. Journal of Bone and Joint Surgery – American Volume 2000;82- A(7):991–1003.
15. Harryman DT, Sidles JA, Harris SL, Matsen III FA. The role of the rotator interval capsule in passive motion and stability of the shoulder. Journal of Bone and Joint Surgery – American Volume 1992;74(1):53–66.
16. Itoi E, Berglund LJ, Grabowski JJ, et al. Superior–inferior stability of the shoulder: role of the coracohumeral ligament and the rotator interval capsule. Mayo Clinic Proceedings 1998;73(6):508–15.
17. Itoi E, Lee SB, Berglund LJ, et al. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. Journal of Bone and Joint Surgery – American Volume 2000;82(1):35–46.
18. Jobe FW, Giangarra CE, Kvitne RS, Glousman RE. Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports. American Journal of Sports Medicine 1919;428–34.
19. Karlsson J, Magnusson L, Ejerhed L, et al. Comparison of open and arthroscopic stabilization for recurrent shoulder dislocation in patients with a Bankart lesion. American Journal of Sports Medicine 2001;29(October (5)):538–42.
20. Kim SH, Ha KI, Cho YB, et al. Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. Journal of Bone and Joint Surgery – American Volume 2003;85-A(8):1511–8.
21. Mazzocca AD, Brown Jr FM, Carreira DS, et al. Arthroscopic anterior shoulder stabilization of collision and contact athletes. American Journal of Sports Medicine 2005;33(1):52–60.
22. Ozbaydar MU, Tonbul M, Baca E, Yalaman O. Arthroscopic treatment of anterior– inferior shoulder instability. Acta Orthopaedica et Traumatologica Turcica 2007;41:120–6.
23. Sugaya H, Moriishi J, Kanisawa I, Tsuchiya A. Arthroscopic osseous Bankart repair for chronic recurrent traumatic anterior glenohumeral instability. Journal of Bone and Joint Surgery – American Volume 2005;87(8):1752–60.
24. Tauro JC. Arthroscopic inferior capsular split and advancement for anterior and inferior shoulder instability: technique and results at 2- to 5-year follow-up. Arthroscopy 2000;16:451–6.
25. Uhorchak JM, Arciero RA, Huggard D, Taylor DC. Recurrent shoulder instability after open reconstruction in athletes involved in collision and contact sports. American Journal of Sports Medicine 2000;28(December (6)):794–9.
26. Urayama M, Itoi E, Hatakeyama Y, et al. Function of the 3 portions of the inferior glenohumeral ligament: a cadaveric study. Journal of Shoulder and Elbow Surgery 2001;10(December (6)):589–94.
27. Westerheide KJ, Dopirak RM, Snyder SJ. Arthroscopic anterior stabilization and posterior capsular plication for anterior glenohumeral instability: a report of 71 cases. Arthroscopy 2006;22:539–47.
edited by hgc6932 2010.10.15