Frank R M, Romeo A A
CU Sports Medicine, Department of Orthopedics, University of Colorado School of Medicine, 2150 Stadium Drive, 80309, Boulder, CO, USA.
Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Suite 300, 60612, Chicago, IL, USA.
Orthopade. 2018 Feb;47(2):121-128. doi: 10.1007/s00132-018-3532-9.
Anterior glenohumeral instability remains a difficult problem in the athletic and working patient populations. Treatment strategies are variable and range from nonoperative approaches incorporating immobilization and rehabilitation to surgical management. Surgical decision-making can be challenging, especially with a high-level patient who wishes to return to high-demand activities. Operative options range from open soft tissue stabilization to arthroscopic soft tissue stabilization, with both open and arthroscopic options for bony reconstruction in the setting of clinically significant anterior glenoid bone loss. In all cases, understanding appropriate indications and utilizing sound surgical techniques are critical for achieving a successful result. For the majority of patients with anterior shoulder instability, arthroscopic soft tissue reconstruction with suture anchors is a successful, minimally invasive approach that results in a stable shoulder with excellent outcomes and low complication rates.
肩关节前向不稳在运动员和工作人群中仍然是一个难题。治疗策略多种多样,从采用固定和康复的非手术方法到手术治疗。手术决策可能具有挑战性,尤其是对于希望恢复高强度活动的高水平患者。手术选择范围从开放软组织稳定术到关节镜下软组织稳定术,在存在临床上明显的肩胛盂前部骨丢失的情况下,开放和关节镜手术均可用于骨重建。在所有情况下,了解合适的适应症并采用可靠的手术技术对于取得成功的结果至关重要。对于大多数肩关节前向不稳的患者,使用缝线锚钉进行关节镜下软组织重建是一种成功的微创方法,可使肩关节稳定,效果极佳且并发症发生率低。