Okamura Kenji, Takiuchi Toshiro, Aoki Mitsuhiro, Ishii Seiichi
Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Japan.
Arthroscopy. 2005 Feb;21(2):194-9. doi: 10.1016/j.arthro.2004.10.020.
Morphological changes after repair of the glenoid labrum were examined using fresh cadavers and clinical cases to compare the anchor and Caspari methods.
Cadaveric and case series.
The depth of the glenoid concavity after Bankart repair was measured in 4 shoulders from 2 fresh cadavers. We made positive models of the glenoid cavity with gypsum and measured the distance from the lateral-most extent of the anterior labrum to the medial extent of the glenoid cavity. We also compared the depth of glenoid concavity in clinical cases between the anchor and Caspari methods using air computed tomography arthrography and magnetic resonance imaging.
We determined the effective depth as the distance from the lateral-most extent of the anterior labrum to the medial extent of the glenoid cavity. The effective depth in fresh cadaver experiments after the anchor method showed substantial differences at the superior and middle levels of the glenoid labrum compared with the Caspari method. Mean effective depths in clinical cases were 5.8 mm (range, 4.2 to 6.8 mm) after the anchor method and 3.5 mm (range, 2.0 to 5.0 mm) after the Caspari method. Effective depth following the anchor method was significantly greater than that of the Caspari method.
During repair of Bankart lesions for traumatic anterior instability of the shoulder, effective depth was higher following use of the anchor method than with the Caspari method.
Understanding the shape of the anterior labrum and glenoid concavity after use of the anchor and Caspari methods may help to improve the surgical technique and clinical results of arthroscopic Bankart repair.
使用新鲜尸体和临床病例检查肩胛盂唇修复后的形态变化，以比较锚钉法和卡斯帕里法。
尸体研究和病例系列研究。
在2具新鲜尸体的4个肩部测量Bankart修复后肩胛盂凹的深度。我们用石膏制作肩胛盂腔的阳性模型，并测量前盂唇最外侧到肩胛盂腔内侧的距离。我们还使用空气计算机断层扫描关节造影和磁共振成像比较了临床病例中锚钉法和卡斯帕里法的肩胛盂凹深度。
我们将有效深度确定为前盂唇最外侧到肩胛盂腔内侧的距离。与卡斯帕里法相比，锚钉法在新鲜尸体实验中，肩胛盂唇上半部分和中间部分的有效深度存在显著差异。临床病例中，锚钉法后的平均有效深度为5.8毫米（范围4.2至6.8毫米），卡斯帕里法后的平均有效深度为3.5毫米（范围2.0至5.0毫米）。锚钉法后的有效深度显著大于卡斯帕里法。
在修复因创伤性肩关节前脱位导致的Bankart损伤时，锚钉法后的有效深度高于卡斯帕里法。
了解使用锚钉法和卡斯帕里法后前盂唇和肩胛盂凹的形状，可能有助于改进关节镜下Bankart修复的手术技术和临床效果。
