Boileau Pascal, Hardy Marie-Béatrice, McClelland Walter B, Thélu Charles-Edouard, Schwartz Daniel G
Department of Orthopaedics & Sports Traumatology, L'Archet Hospital, University of Nice Sophia-Antipolis, Nice, France.
Arthrosc Tech. 2013 Nov 8;2(4):e473-7. doi: 10.1016/j.eats.2013.07.004. eCollection 2013 Nov.
We present a novel all-arthroscopic technique of posterior shoulder stabilization that uses suture anchors for both bone block fixation and capsulolabral repair. The bone graft, introduced inside the glenohumeral joint through a cannula, is fixed with 2 suture anchors. The associated posteroinferior capsulolabral repair places the bone block in an extra-articular position. In this article we present the detailed arthroscopic technique performed in a consecutive series of 15 patients and report the early results. We also report the positioning, healing, and remodeling of the bone block using postoperative 3-dimensional computed tomography. The benefits of this new technique are as follows: (1) it is all arthroscopic, preserving the posterior deltoid and posterior rotator cuff muscles; (2) it is accurate, resulting in appropriate bone block positioning; (3) it is efficient, allowing for consistent bone graft healing; (4) it is anatomic, both restoring the glenoid bone stock and repairing the injured posterior labrum; and (5) it is safe, limiting hardware-related complications and eliminating the risk of injury to vital structures associated with drilling or screw insertion from posterior to anterior. We believe that this technique is advantageous because it does not use screws for fixation and may be safer for the patient.
我们介绍一种新型的全关节镜下肩关节后向稳定技术，该技术使用缝线锚钉进行骨块固定和盂唇修复。通过套管将骨移植块引入盂肱关节内，并用2个缝线锚钉固定。相关的后下盂唇修复将骨块置于关节外位置。在本文中，我们介绍了对连续15例患者实施的详细关节镜技术，并报告了早期结果。我们还使用术后三维计算机断层扫描报告了骨块的定位、愈合和重塑情况。这项新技术的优点如下：（1）全关节镜操作，保留了三角肌后部和肩袖后群肌肉；（2）准确，可实现骨块的恰当定位；（3）高效，能使骨移植块持续愈合；（4）符合解剖学，既能恢复肩胛盂骨量，又能修复受损的后盂唇；（5）安全，可减少与硬件相关的并发症，并消除从后向前钻孔或拧入螺钉时对重要结构造成损伤的风险。我们认为这项技术具有优势，因为它不使用螺钉进行固定，对患者可能更安全。
