St John of God Hospital and Geelong Hospital, Geelong, VIC 3220, Australia.
Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1748-51. doi: 10.1007/s00167-010-1095-3. Epub 2010 Mar 10.
Chondrolabral lesions are uncommon after anteroinferior glenohumeral dislocations. This report describes a new dual-lesion complex that involved an avulsion of the anteroinferior glenoid labrum and a flap tear of the adjacent articular cartilage [glenoid labral tear and articular cartilage flap (GLAF) lesion]. The chondral component involved a large undermined region of the anterior half of the lower glenoid articular cartilage, and the labral component involved an avulsion from the 2.30-6 o'clock position on the glenoid. The labral tear was reconstructed with 3 suture anchors to form a neo-labrum in an attempt to overlap and stabilize the periphery of the chondral flap. A meniscal repair device was used to place a mattress stitch in the cartilage periphery to further stabilize the flap. This technique resulted in a secure repair without any chondral damage, and this remained intact on an MRI performed at a 3-month follow-up. A final 12-month follow-up showed complete recovery, as assessed by the Oxford shoulder instability score and Rowe score, and by a return to the pre-injury sporting level.
盂唇软骨损伤在盂肱关节前下脱位后并不常见。本报告描述了一种新的双重损伤复合体,包括盂唇前下区撕脱和相邻关节软骨的瓣状撕裂[盂唇撕裂伴关节软骨瓣(GLAF)损伤]。软骨损伤累及肩胛盂前下部关节软骨的大面积薄弱区,盂唇损伤自肩胛盂 2 点 30 分至 6 点区撕脱。采用 3 枚缝线锚钉重建盂唇,形成新的盂唇,试图覆盖和稳定软骨瓣的边缘。半月板修复装置用于在软骨边缘行褥式缝合,进一步稳定瓣状结构。该技术可实现牢固修复,无软骨损伤,且在 3 个月随访的 MRI 上未发现异常。末次随访(12 个月)时,根据牛津肩关节不稳定评分和 Rowe 评分,以及恢复到损伤前运动水平评估,患者完全康复。