Mochizuki Yu, Hachisuka Hiroki, Kashiwagi Kenji, Oomae Hiromichi, Yokoya Shin, Ochi Mitsuo
Department of Orthopaedic Surgery, Programs for Applied Biomedicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Arthroscopy. 2007 Jun;23(6):677.e1-4. doi: 10.1016/j.arthro.2006.01.024. Epub 2006 Nov 27.
Many clinicians believe that a large bony defect of the glenoid must be treated with bone grafting when a Bankart procedure is performed. Various types of bone graft, such as open bone graft, Eden-Hybinnette, J-bone graft, coracoid transfer, and Latarjet, have been used. These require open procedures that are difficult to perform arthroscopically. We performed an arthroscopic autologous bone graft and an arthroscopic Bankart repair at the same time to treat a patient with recurrent dislocation of the shoulder joint and a large bony Bankart lesion. We harvested from the lateral site of the acromion 2 bones that were 2.7 mm in cylindrical diameter. We transplanted these bones to the large bony defect of the anteroinferior area of the glenoid and placed anchors between the 2 plugs. During the 30 months since the surgery was performed, the patient has not experienced dislocation or apprehension about the shoulder. A 3-dimensional computed tomography scan showed enlargement of the glenoid surface. Our surgical procedure offers promise for treatment of patients with recurrent dislocation of the shoulder joint and a large bony Bankart lesion because it allows the surgeon to alter the size and the grafted site of the cylindrical bone according to the size of the defect.
许多临床医生认为，在进行Bankart手术时，肩胛盂的大骨缺损必须采用骨移植治疗。已经使用了各种类型的骨移植，如开放骨移植、伊登-海宾内特法、J形骨移植、喙突转移术和拉塔热手术。这些都需要开放手术，难以通过关节镜进行。我们同时进行了关节镜下自体骨移植和关节镜下Bankart修复术，以治疗一名复发性肩关节脱位且伴有大的骨性Bankart损伤的患者。我们从肩峰外侧部位获取了2块圆柱直径为2.7毫米的骨头。我们将这些骨头移植到肩胛盂前下区域的大骨缺损处，并在2个骨栓之间放置锚钉。自手术实施后的30个月里，该患者未出现肩关节脱位或恐惧现象。三维计算机断层扫描显示肩胛盂表面增大。我们的手术方法为治疗复发性肩关节脱位且伴有大的骨性Bankart损伤的患者带来了希望，因为它使外科医生能够根据缺损大小改变圆柱骨的尺寸和移植部位。
