Ambacher T
ARCUS Kliniken Pforzheim, Deutschland.
Orthopade. 2011 Jan;40(1):31-4, 36-40. doi: 10.1007/s00132-010-1677-2.
Current data show that the majority of patients in Germany with shoulder instability caused by soft tissue lesions are treated arthroscopically. The published redislocation rates in retrospective studies are less than 10%. Currently most surgeons prefer to use special strong suture materials and bioabsorbable suture anchors with a trend for knotless anchors. Some authors have published special techniques for labrum repair including double row fixation to increase the pull out force of the sutures but further prospective studies are necessary to prove whether these techniques can reduce the redislocation rate. In cases of extended anterior pouch of the capsule and in non-traumatic instability, capsular plication and interval closure can be indicated. There are still no clear objective parameters concerning indications or amount of plication and interval closure.
目前的数据表明,德国大多数因软组织损伤导致肩关节不稳定的患者接受关节镜治疗。回顾性研究中公布的再脱位率低于10%。目前,大多数外科医生倾向于使用特殊的高强度缝合材料和可生物吸收的缝合锚钉,并且有无结锚钉的趋势。一些作者发表了特殊的盂唇修复技术,包括双排固定以增加缝线的拔出力,但需要进一步的前瞻性研究来证明这些技术是否能降低再脱位率。在关节囊前袋扩展和非创伤性不稳定的情况下,可以考虑进行关节囊折叠和间隙闭合。关于折叠和间隙闭合的适应症或程度,仍然没有明确的客观参数。