Ho Anthony G, Gowda Ashok L, Michael Wiater J
Department of Orthopaedic Surgery, Beaumont Health, 3535 W. Thirteen Mile Rd, Suite 744, Royal Oak, MI, 48073, USA.
J Orthop Traumatol. 2016 Sep;17(3):187-97. doi: 10.1007/s10195-016-0409-8. Epub 2016 Jun 15.
Management of the unstable shoulder after a failed stabilization procedure can be difficult and challenging. Detailed understanding of the native shoulder anatomy, including its static and dynamic restraints, is necessary for determining the patient's primary pathology. In addition, evaluation of the patient's history, physical exam, and imaging is important for identifying the cause for failure after the initial procedure. Common mistakes include under-appreciation of bony defects, failure to recognize capsular laxity, technical errors, and missed associated pathology. Many potential treatment options exist for revision surgery, including open or arthroscopic Bankart repair, bony augmentation procedures, and management of Hill Sachs defects. The aim of this narrative review is to discuss in-depth the common risk factors for post-surgical failure, components for appropriate evaluation, and the different surgical options available for revision stabilization. Level of evidence Level V.
稳定手术失败后不稳定肩关节的处理可能困难且具有挑战性。详细了解原生肩关节解剖结构，包括其静态和动态约束，对于确定患者的主要病理状况是必要的。此外，评估患者的病史、体格检查和影像学检查对于识别初次手术后失败的原因很重要。常见错误包括对骨缺损认识不足、未认识到关节囊松弛、技术错误以及遗漏相关病理情况。翻修手术有许多潜在的治疗选择，包括开放或关节镜下Bankart修复、骨增强手术以及Hill-Sachs缺损的处理。本叙述性综述的目的是深入讨论手术后失败的常见风险因素、适当评估的组成部分以及可用于翻修稳定的不同手术选择。证据级别：V级。
