Pope E Jeffrey, Ward James P, Rokito Andrew S
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases New York, NY, USA.
Bull NYU Hosp Jt Dis. 2011;69(1):44-9.
The glenohumeral joint is the most commonly dislocated joint in the body. The prevalence of this condition and the instability that may result from it has been a focus of diagnosis and treatment since the original description of the Bankart lesion in 1923. Now, with the introduction of MRI, lesions causing anterior shoulder instability can be diagnosed more accurately. This has led to improved understanding of the pathoanatomy that must be addressed and corrected during surgical repair. Initial attempts at arthroscopic treatment, including staple repair, transosseus suture repair, rivets, and thermal capsulorraphy were fraught with complications and unacceptably high recurrence rates. The development of arthroscopic suture anchors have revolutionized the treatment of anterior shoulder instability, such that arthroscopic management is now the standard of care. In the hands of experienced surgeons, outcomes for arthroscopic treatment of shoulder instability now approaches the success of open treatment.
盂肱关节是人体最常发生脱位的关节。自1923年首次描述Bankart损伤以来,这种疾病的患病率及其可能导致的不稳定一直是诊断和治疗的重点。如今,随着MRI的引入,可更准确地诊断导致前肩不稳的损伤。这使得人们对手术修复过程中必须处理和纠正的病理解剖结构有了更深入的认识。早期的关节镜治疗尝试,包括钉合修复、经骨缝合修复、铆钉和热囊缝合术,都充满了并发症且复发率高得令人难以接受。关节镜缝合锚的发展彻底改变了前肩不稳的治疗方式,以至于关节镜治疗现在已成为标准治疗方法。在经验丰富的外科医生手中,关节镜治疗肩不稳的效果现已接近开放治疗的成功率。