Wong Ivan H, Urquhart Nathan
Dalhousie University and the Division of Orthopaedic Surgery, Capital District Health Authority, Halifax, Nova Scotia, Canada.
Arthrosc Tech. 2015 Sep 21;4(5):e449-56. doi: 10.1016/j.eats.2015.04.005. eCollection 2015 Oct.
The role of bone loss from the anterior glenoid in recurrent shoulder instability has been well established. We present a completely arthroscopic technique for reconstructing the anterior glenoid with distal tibial allograft and without a subscapularis split. We perform the arthroscopy in the lateral position. We measure and size an allograft distal tibial graft and place it arthroscopically. We use an inside-out medial portal to introduce the graft into the shoulder, passing it through the rotator interval and above the subscapularis. A double-cannula system is used to pass the graft, which is temporarily fixed with K-wires and held in place with cannulated screws. We then perform a Bankart-like repair of the soft tissues to balance the shoulder and augment our repair. Our technique is not only anatomic in the re-creation of the glenoid surface but also anatomic in the preservation of the coracoid and subscapularis tendon and repair of the capsulolabral complex.
前盂肱关节骨质流失在复发性肩关节不稳中的作用已得到充分证实。我们介绍一种完全关节镜下技术，用于使用异体胫骨远端移植重建前盂肱关节，且无需劈开肩胛下肌。我们在侧卧位进行关节镜检查。我们测量并确定异体胫骨远端移植块的尺寸，然后通过关节镜放置。我们使用由内向外的内侧入路将移植块引入肩部，使其穿过旋转间隙并位于肩胛下肌上方。使用双套管系统传递移植块，移植块先用克氏针临时固定，再用空心螺钉固定在位。然后我们进行类似Bankart手术的软组织修复，以平衡肩关节并加强修复。我们的技术不仅在重建盂肱关节表面时符合解剖结构，而且在保留喙突和肩胛下肌腱以及修复关节囊盂唇复合体方面也符合解剖结构。
