Meyer Dominik C, Gerber Christian, Familiari Filippo
Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Department of Orthopaedic and Trauma Surgery, Magna Graecia University, Catanzaro, Italy.
Arthrosc Tech. 2017 Oct 12;6(5):e1553-e1557. doi: 10.1016/j.eats.2017.06.015. eCollection 2017 Oct.
The simultaneous arthroscopic exposure of the subacromial and intra-articular space of the shoulder is challenging in the presence of only partial-thickness rotator cuff tears. We present our experience and method of entering the joint through the opened rotator cuff interval from an anterosuperior portal between the coracoid process and anterior acromion. With moderate (approximately 30°) abduction and external rotation, the rotator interval opens readily, offering a view with the camera toward the anterior edge of the supraspinatus tendon. An anterior view on the anterior leading edge of the supraspinatus tendon is obtained, showing the subacromial space above and the glenohumeral space below the tendon, similar to the view in an aquarium. The rotator cuff can be elevated using a rod inserted intra-articularly from posterior, whereas anchors and other instruments may be inserted from lateral. This approach offers the advantages of full exposure of the posterior undersurface of the rotator cuff insertion; a convenient approximately 90° angle between the camera and instruments; and no need to change portals for anchor placement, tendon stitching, or suture handling. The objective of this Technical Note is to describe our arthroscopic repair approach (aquarium technique) to PASTA (partial articular supraspinatus tendon avulsion) lesions.
在仅存在部分厚度肩袖撕裂的情况下，同时通过关节镜暴露肩部的肩峰下间隙和关节内间隙具有挑战性。我们介绍了我们从喙突和肩峰前上方之间的前上入口通过开放的肩袖间隙进入关节的经验和方法。在适度（约30°）外展和外旋的情况下，肩袖间隙很容易打开，通过摄像头可以看到冈上肌肌腱的前缘。可以获得冈上肌肌腱前缘的前视图，显示肌腱上方的肩峰下间隙和下方的盂肱间隙，类似于在水族馆中的视图。可以使用从后方插入关节内的杆抬起肩袖，而锚钉和其他器械可以从外侧插入。这种方法具有以下优点：完全暴露肩袖插入部的后下表面；摄像头和器械之间形成方便的约90°角；无需为放置锚钉、缝合肌腱或处理缝线而更换入口。本技术说明的目的是描述我们对部分关节面冈上肌肌腱撕脱（PASTA）损伤的关节镜修复方法（水族馆技术）。
