Alexander Thomas C, Beicker Clint, Tokish John M
Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, South Carolina, U.S.A.
Arthrosc Tech. 2016 Aug 29;5(5):e975-e979. doi: 10.1016/j.eats.2016.04.022. eCollection 2016 Oct.
Humeral bone loss has been shown to be a risk factor for failure after arthroscopic treatment of instability. We present the arthroscopic remplissage technique originally described by Koo and Burkhart et al. with a modification in the percutaneous anchor placement and suture tying that is reproducible and effective. We percutaneously place 2 suture anchors, which require no additional suture passing across the tissue, to create a double pulley technique, filling the defect with posterior capsule and rotator cuff. Therefore, the Hill-Sachs defect becomes extra-articular, eliminating the potential engagement of the anterior glenoid and contribution to recurrence of instability. This technique is applicable broadly for most Hill-Sachs lesions that need addressing. By not having to pass or shuttle any suture through tissue after anchor placement and by eliminating the necessity to go subacromially to retrieve or tie suture, the technique saves time and improves reproducibility. The compression of tissue into the Hill Sachs surface area also is improved by double-reinforced suturing through the double-pulley technique. The combination of these advantages creates a sound and efficient technique for remplissage.
肱骨骨质流失已被证明是关节镜治疗肩关节不稳后失败的一个风险因素。我们介绍了最初由Koo和Burkhart等人描述的关节镜下充填技术，并对经皮锚钉置入和缝线打结进行了改进，该技术具有可重复性且有效。我们经皮置入2枚缝线锚钉，无需额外的缝线穿过组织，以创建双滑轮技术，用后关节囊和肩袖填充缺损。因此，希尔-萨克斯缺损变为关节外缺损，消除了前关节盂潜在的嵌顿以及对不稳复发的影响。该技术广泛适用于大多数需要处理的希尔-萨克斯损伤。通过在置入锚钉后无需将任何缝线穿过组织，以及无需在肩峰下取线或打结，该技术节省了时间并提高了可重复性。通过双滑轮技术进行双重加强缝合，也改善了组织向希尔-萨克斯表面区域的压缩。这些优点的结合创造了一种可靠且高效的充填技术。
