From the Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO (Dr. Seidl), and the Department of Orthopaedic Surgery, Seton Hall-Hackensack Meridian School of Medicine, South Orange, NJ (Dr. Kraeutler).
J Am Acad Orthop Surg. 2018 Jun 1;26(11):e230-e237. doi: 10.5435/JAAOS-D-17-00057.
Articular cartilage defects are not often encountered in the glenohumeral joint. These lesions are typically found in patients with shoulder trauma, recurrent instability, or previous surgical treatment. Diagnosis can be difficult; these defects are often found incidentally during arthroscopic or open surgical management of other pathology. Initial management of isolated glenohumeral chondral defects is nonsurgical and includes physical therapy and/or corticosteroid injections. If nonsurgical treatment is unsuccessful, patients may undergo surgery. Because these lesions occur infrequently, few studies have documented surgical techniques and outcomes. Surgical strategies include arthroscopic débridement, microfracture surgery, osteochondral autograft or allograft transplantation, autologous chondrocyte implantation, and particulated juvenile allograft cartilage implantation.
肩盂肱关节很少出现关节软骨缺损。这些病变通常发生于肩部创伤、复发性不稳定或既往手术治疗的患者中。诊断较为困难，这些缺损通常在关节镜或开放性手术治疗其他病变时偶然发现。孤立性肩盂肱软骨缺损的初始治疗为非手术治疗，包括物理治疗和/或皮质类固醇注射。如果非手术治疗无效，患者可能需要手术。由于这些病变较为罕见，因此很少有研究记录手术技术和结果。手术策略包括关节镜清创术、微骨折手术、骨软骨自体或同种异体移植、自体软骨细胞移植和颗粒状幼年同种异体软骨移植。
