Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Arthroscopy. 2011 Jan;27(1):129-35. doi: 10.1016/j.arthro.2010.09.012.
Failure to address glenoid deficiency/osteochondral defects can lead to persistent shoulder instability despite a surgical stabilization procedure. In patients with significant glenoid bone loss, osteoarticular allograft transplantation has the potential benefit of restoring normal glenohumeral anatomy. It may also reduce the risk of recurrent instability and permit near-normal postoperative range of motion while avoiding the complications of nonanatomic reconstruction techniques. Numerous open methods of anatomic glenoid reconstruction have been described, including the use of iliac crest autograft, distal tibia allograft, and glenoid allograft. Our purpose is to review the literature regarding the surgical treatment of glenoid bone deficiency. We also describe a novel technique of arthroscopic anteroinferior glenoid reconstruction using glenoid osteochondral allograft without subscapularis takedown. The potential risks and benefits of our technique are also discussed.
如果不解决肩胛盂缺损/骨软骨缺陷问题，尽管进行了手术稳定化处理，仍可能导致持续性肩关节不稳定。对于存在明显肩胛盂骨丢失的患者，关节骨软骨同种异体移植具有恢复正常盂肱解剖结构的潜在益处。它还可能降低复发性不稳定的风险，并允许术后接近正常的活动范围，同时避免非解剖重建技术的并发症。已经描述了许多开放性解剖肩胛盂重建方法，包括使用髂嵴自体移植物、胫骨远端同种异体移植物和肩胛盂同种异体移植物。我们的目的是回顾有关肩胛盂骨缺损的外科治疗的文献。我们还描述了一种使用肩胛盂骨软骨同种异体移植物进行关节镜下前下肩胛盂重建的新方法，无需切除肩胛下肌。还讨论了我们技术的潜在风险和益处。
