Skip to main content
SpringerLink
Log in

Arthroskopische vs. offene ventrale Schulterstabilisierung

Eine Wertung

Arthroscopic versus open anterior shoulder stabilization

A systematic validation

  • Leitthema
  • Published:
Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Die Behandlung der traumatischen vorderen Schulterinstabilität hat in den vergangenen 2 Jahrzehnten häufig kontroverse Diskussionen verursacht. Einigkeit herrscht jedoch über die Notwendigkeit einer dem Verletzungsmechanismus, dem Ausprägungsgrad der vorliegenden Instabilität und dem Funktionsanspruch des Patienten in Bezug auf Beruf und Sport individuell angepassten Behandlung. Die offene Rekonstruktion des ventralen Kapsel-Labrum-Komplexes galt über lange Jahre als Therapie der Wahl. Mittlerweile zeigen die Ergebnisse nach arthroskopischer Kapsel-Labrum-Refixation eine zunehmende Annäherung an die Ergebnisse der offenen Techniken. Insbesondere durch den Einsatz von Fadenankern scheint es möglich, die Prinzipien der klassischen offenen Bankart-Operation zu imitieren und so die allgemeinen Vorteile arthroskopischer Operationstechniken mit einer niedrigen Rezidivrate zu kombinieren.

Abstract

The treatment of traumatic anterior glenohumeral instability has been a topic of debate over the last couple of decades. However, a consensus exists regarding the necessity of an individualized treatment plan based on the type and degree of instability and the patient’s functional demands. Various open and arthroscopic techniques are among the currently used surgical procedures. Open reconstruction of the capsulolabral complex had been considered the treatment of choice for many years, but the latest results for arthroscopic anterior shoulder stabilization demonstrate its increasing use. The current literature suggests that with the introduction of suture anchors, it is possible to mirror the principles of open anterior shoulder stabilization and thus combine the general advantages of arthroscopic surgery with a low recurrence rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Balg F, Boileau P (2007) The instability severity index score. J Bone Joint Sur Br 89: 1470–1477

    Article  CAS  Google Scholar 

  2. Bankart ASB (1923) Recurrent or habitual dislocation of the shoulder. Br Med J 2: 1131–1133

    Article  Google Scholar 

  3. Bankart ASB (1938) The pathology and treatment of recurrent dislocation of the shoulder joint. Br J Surg 26: 23–29

    Article  Google Scholar 

  4. Bigliani LU, Kurzweil PR, Schwartzbach CC et al (1994) Inferior capsular shift procedure for anterior-inferior shoulder instability in athletes. Am J Sports Med 22: 578–584

    Article  PubMed  CAS  Google Scholar 

  5. Bottoni CR, Smith EL, Berkowitz MJ et al (2006) Arthroscopic versus open shoulder stabilization for recurrent anterior instability: a prospective randomized clinical trial. Am J Sports Med 34: 1730–1737

    Article  PubMed  Google Scholar 

  6. Carreira DS, Mazzocca AD, Oryon J et al (2006) A prospective outcome evaluation of arthroscopic Bankart repairs: minimum 2-year follow-up. Am J Sports Med 34: 771–777

    Article  PubMed  Google Scholar 

  7. Caspari RB, Savoie FH (1991) Arthroscopic reconstruction of the shoulder: The bankart repair: In: McGinty JB (Hrsg) Operative arthroscopy. Raven Press, New York, pp 507–515

  8. Fabbriciani C, Milano G, Demontis A et al (2004) Arthroscopic versus open treatment of bankart lesion of the shoulder: a prospective randomized study. Arthroscopy 20: 456–462

    PubMed  Google Scholar 

  9. Freedman KB, Smith AP, Romeo AA et al (2004) Open bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder. Am J Sports Med 32: 1520–1527

    Article  PubMed  Google Scholar 

  10. Gartsman GM, Roddey TS, Hammerman SM (2001) Arthroscopic treatment of bi-directional instability: Two- to five-year follow-up. J Shoulder Elbow Surg 10: 28–36

    Article  PubMed  CAS  Google Scholar 

  11. Gill TJ, Micheli LJ, Gebhard F, Binder C (1997) Bankart repair for anterior instability of the shoulder. Long-term outcome. J Bone Joint Surg Am 79: 850–857

    PubMed  CAS  Google Scholar 

  12. Green MR, Christensen KP (1993) Arthroscopic versus open bankart procedures: A comparison of early morbidity and complications. Arthroscopy 9: 371–374

    PubMed  CAS  Google Scholar 

  13. Hobby J, Griffin D, Dunbar M, Boileau P (n d) Is arthroscopic surgery for stabilisation of chronic shoulder instability as effective as open surgery? J Bone Joint Surg Br 89: 1188–1196

  14. Johnson LL (1986) Shoulder arthroscopy: In: Johnson LL (Hrsg) Arthroscopic surgery: principles and practice. CV, St. Louis, pp 180

  15. Jorgensen U, Svend-Hansen H, Bak K, Pedersen I (1999) Recurrent post-traumatic anterior shoulder dislcoation – open versus arthroscopic repair. Knee Surg Sports Traumatol Arthrosc 7: 118–124

    Article  PubMed  CAS  Google Scholar 

  16. Karlsson J, Magnusson L, Ejerhed L et al (2001) Comparison of open and arthroscopic stabilization for recurrent shoulder dislocation in patients with a Bankart lesion. Am J Sports Med 29: 538–542

    PubMed  CAS  Google Scholar 

  17. Kartus J, Ejerhed L, Funck E et al (1998) Arthroscopic and open shoulder stabilization using absorbable implants. A clinical and radiographic comparison of two methods. Knee Surg Sports Traumatol Arthrosc 6: 181–188

    Article  PubMed  CAS  Google Scholar 

  18. Kim S-H, Ha K-I, Kim S-H (2002) Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy 18: 755–763

    PubMed  Google Scholar 

  19. Lenters TR, Franta AK, Wolf FM et al (2007) Arthroscopic compared with open repairs for recurrent anterior shoulder instability. A systematic review and meta-analysis of the literature. J Bone Joint Surg Am 89: 244–254

    Article  PubMed  Google Scholar 

  20. Levine WN, Richmond J, Donaldson W (1994) Use of the suture anchor in open bankart reconstruction: A follow-up report. Am J Sports Med 22: 723–726

    Article  PubMed  CAS  Google Scholar 

  21. Marquardt B, Witt KA, Liem D et al (2006) Arthroscopic bankart repair in traumatic anterior shoulder instability using a suture anchor technique. Arthroscopy 22: 931–936

    PubMed  Google Scholar 

  22. Marquardt B, Witt KA, Liem D et al (2006) Longterm results of arthroscopic bankart repair with a bioabsorbable tack. Am J Sports Med 34: 1906–1910

    Article  PubMed  Google Scholar 

  23. Mohtadi NGH, Bitar IJ, Sasyniuk TM et al (2005) Arthroscopic versus open repair for traumatic anterior shoulder instability: a meta-analysis. Arthroscopy 21: 652–658

    PubMed  Google Scholar 

  24. Morgan CD, Bodenstab AB (1987) Arthroscopic bankart suture repair: Technique and early results. Arthroscopy 3: 111–122

    PubMed  CAS  Google Scholar 

  25. Perthes G (1906) Über Operationen bei habitueller Schulterluxation. Dtsch Z Chir 85: 199–227

    Google Scholar 

  26. Pötzl W, Witt KA, Hackenberg L et al (2003) Results of suture anchor repair of anteroinferior shoulder instability: a prospective clinical study of 85 shoulders. J Shoulder Elbow Surg 12: 322–326

    Article  PubMed  Google Scholar 

  27. Resch H, Povacz P, Wambacher M et al (1997) Arthroscopic extra-articular bankart repair for the treatment of recurrent anterior shoulder dislocation. Arthroscopy 13: 188–200

    Article  PubMed  CAS  Google Scholar 

  28. Rowe CR, Patel D, Southmayd WW (1978) The bankart procedure: A long-term end result study. J Bone Joint Surg Am 60: 1–16

    PubMed  CAS  Google Scholar 

  29. Scheibel M, Nikulka C, Dick A et al (2007) Structural integrity and clinical function of the subscapularis musculotendinous unit after arthroscopic and open shoulder stabilization. Am J Sports Med 35: 1153–1161

    Article  PubMed  Google Scholar 

  30. Segmuller HE, Hayes MG, Saies AD (1998) Arthroscopic repair of glenolabral injuries with an absorbable fixation device. J Shoulder Elbow Surg 6: 383–392

    Article  Google Scholar 

  31. Speer KP, Warren RF, Pagnani M, Warner JJ (1996) An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg 78: 1801–1807

    PubMed  CAS  Google Scholar 

  32. Sperber A, Hamberg P, Karlsson J et al (2001) Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: A prospective, randomized multicenter study. J Shoulder Elbow Surg 10: 105–108

    Article  PubMed  CAS  Google Scholar 

  33. Steinbeck J, Jerosch J (1998) Arthroscopic transglenoid stabilization versus open anchor suturing in traumatic anterior instability of the shoulder. Am J Sports Med 26: 373–378

    PubMed  CAS  Google Scholar 

  34. Walch G, Boileau P, Levigne C et al (1995) Arthroscopic stabilization for recurrent anterior shoulder dislocation: results of 59 cases. Arthroscopy 11: 173–179

    PubMed  CAS  Google Scholar 

  35. Wolf EM, Wilk RM, Richmond JC (1991) Arthroscopic bankart repair using suture anchors. Operat Tech Orthop 1: 184–191

    Article  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Orthopädische Praxis/Praxisklinik, Von-Vincke-Str. 14, 48143, Münster, Deutschland

    J. Steinbeck, K-A Witt & B. Marquardt

Authors
  1. J. Steinbeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K-A Witt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Marquardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Steinbeck.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Steinbeck, J., Witt, KA. & Marquardt, B. Arthroskopische vs. offene ventrale Schulterstabilisierung. Orthopäde 38, 36–40 (2009). https://doi.org/10.1007/s00132-008-1353-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00132-008-1353-y

Schlüsselwörter

Keywords

Search

Navigation