Arthroscopy. 2018 Feb;34(2):360-362. doi: 10.1016/j.arthro.2017.10.002.
Arthroscopic techniques are an emerging technology to deal with glenoid bone defects in patients with anterior shoulder instability, and improvements are being made to safely minimize the risk of injury to the anterior neurovascular structures including the axillary nerve. Arthroscopic glenoid reconstruction is a technically demanding procedure, but it does have promising short-term outcomes. I truly like the concept of anterior (and also posterior) bone grafting for defects of the glenoid, including the arthroscopic Latarjet. A free bone graft (iliac crest, distal tibia) is part of a logical surgical learning curve progression to treat bone defects from an arthroscopic standpoint. Before performing an arthroscopic Latarjet, I might suggest looking at performing free bone block fixation arthroscopically. But, for now, I still enjoy the success of an open bone grafting procedure and will continue to use open as my primary bone grafting (Latarjet, distal tibia, iliac crest), so as to optimize the position of the graft for successful long-term outcomes. We look forward to seeing more of the authors' work and a longer term follow-up of these patients to clearly delineate the development of osteoarthrosis, recurrent instability, and long-term stability of the bone graft and shoulder joint function.
关节镜技术是一种新兴的技术，用于治疗患有复发性肩关节前不稳定的患者的肩胛盂骨缺损，并且正在改进技术以安全地将损伤前神经血管结构（包括腋神经）的风险降到最低。关节镜下肩胛盂重建是一项技术要求很高的手术，但它确实有有前景的短期结果。我真的很喜欢肩胛盂骨缺损的前（和后）骨移植的概念，包括关节镜下 Latarjet 术。游离骨移植物（髂嵴、胫骨远端）是从关节镜角度治疗骨缺损的逻辑手术学习曲线进展的一部分。在进行关节镜下 Latarjet 术之前，我可能会建议先进行游离骨块固定术。但是，目前，我仍然享受开放植骨手术的成功，并将继续使用开放手术作为我的主要植骨术（Latarjet、胫骨远端、髂嵴），以优化移植物的位置，从而获得成功的长期结果。我们期待看到更多作者的工作和这些患者的长期随访，以明确骨关节炎、复发性不稳定和骨移植物及肩关节功能的长期稳定性的发展。
