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前肩不稳合并肩胛盂骨缺损的治疗:适应证与疗效

Management of Glenoid Bone Loss with Anterior Shoulder Instability: Indications and Outcomes.

作者信息

Rabinowitz Justin, Friedman Richard, Eichinger Josef K

机构信息

Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Curr Rev Musculoskelet Med. 2017 Dec;10(4):452-462. doi: 10.1007/s12178-017-9439-y.

Abstract

PURPOSE OF REVIEW

Glenoid Bone Loss is a commonly encountered problem in anterior shoulder instability. In this article, we review current techniques for diagnosis, indications and management of glenoid bone loss.

RECENT FINDINGS

Multiple bone grafting techniques are available depending on the glenoid defect size including the coracoid, distal clavicle, iliac crest, and allograft distal tibia. Advancement in imaging methods allows for more accurate quantification of bone loss. Indications and techniques are continuing to evolve, and emerging evidence suggests that smaller degrees of bone loss "subcritical" may be best treated with bone grafting. Future directions for innovation and investigation include improved arthroscopic techniques and a refinement of indications for the type of bone grafts and when to indicate a patient of arthroscopic repair versus glenoid bone grafting for smaller degrees of bone loss to ensure successful outcome.

摘要

综述目的

肩胛盂骨缺损是前肩不稳中常见的问题。在本文中,我们回顾了目前肩胛盂骨缺损的诊断技术、适应证及治疗方法。

最新发现

根据肩胛盂缺损大小,有多种骨移植技术可供选择,包括喙突、锁骨远端、髂嵴和异体胫骨远端。成像方法的进步使得骨缺损的量化更加准确。适应证和技术不断发展,新出现的证据表明,较小程度的骨缺损(“临界以下”)可能最好采用骨移植治疗。创新和研究的未来方向包括改进关节镜技术,完善骨移植类型的适应证,以及明确在较小程度骨缺损时何时对患者进行关节镜修复与肩胛盂骨移植,以确保取得成功的治疗效果。

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