Sekiya Jon K
Department of Orthopaedic Surgery, Bone and Joint/Sports Medicine Institute, Naval Medical Center Portsmouth, Virginia 23708, USA.
Arthroscopy. 2005 Jun;21(6):766. doi: 10.1016/j.arthro.2005.03.024.
The arthroscopic treatment of shoulder instability is becoming increasingly popular with recent clinical studies showing similar success rates comparable to open procedures. These improved success rates are likely due to a better understanding of the pathoanatomy of shoulder instability and addressing all injured structures including labral tears and capsular injury and stretching. I present a new arthroscopic technique for shoulder stabilization that makes use of already known techniques by sequentially repairing the labral tear and performing a capsular shift through multiple, separate pleated plications through a single working portal. This technique allows for an anatomic labral repair with a capsular shift as large as desired by performing as many additional tucks of capsule for plication as needed, comparable to open techniques with less surrounding tissue trauma. This technique is actually easier than more traditional arthroscopic methods, and the multiple pleats may provide a load-sharing effect dispersed through each pleat, which may decrease the risk of load failure.
肩关节不稳的关节镜治疗越来越受欢迎，近期临床研究表明其成功率与开放手术相当。这些成功率的提高可能是由于对肩关节不稳的病理解剖有了更好的认识，并对所有受损结构进行了处理，包括盂唇撕裂、关节囊损伤和拉伸。我介绍一种新的肩关节稳定关节镜技术，该技术通过依次修复盂唇撕裂，并通过单个工作通道进行多个单独的折叠襞来进行关节囊移位，利用了已知技术。该技术允许进行解剖学盂唇修复，并通过根据需要进行尽可能多的额外关节囊折叠襞来实现所需大小的关节囊移位，与开放技术相当，但周围组织创伤较小。该技术实际上比更传统的关节镜方法更容易，并且多个褶皱可能提供通过每个褶皱分散的负荷分担效应，这可能降低负荷失败的风险。
