Amar Eyal, Konstantinidis George, Coady Catherine, Wong Ivan H
Department of Orthopedics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Orthop J Sports Med. 2018 May 23;6(5):2325967118774507. doi: 10.1177/2325967118774507. eCollection 2018 May.
The results of arthroscopic anterior labral repair have demonstrated high failure rates in patients with significant glenoid bone loss. Several reconstruction procedures using a bone graft have been developed to overcome bone loss.
The primary objective of this study was to generate a safety profile for arthroscopic anatomic glenoid reconstruction using a distal tibial allograft. The secondary objective was to evaluate the radiological outcomes of patients who underwent this procedure.
Case series; Level of evidence, 4.
This retrospective review included the medical charts and diagnostic images of 42 consecutive patients who underwent arthroscopic shoulder stabilization by means of capsule-labral reattachment and bony augmentation with a distal tibial allograft. The safety profile was measured by detecting intraoperative or postoperative complications, including neurovascular (nerves and blood vessels) injuries, bleeding, infections, and dislocations. A radiological evaluation was conducted by assessing computed tomography (CT) scans obtained preoperatively and at approximately 6 months postoperatively.
A total of 42 patients (29 male, 13 female) with a mean age of 26.73 ± 9.01 years were included. An excellent safety profile was observed, with no intraoperative complications, neurovascular injuries, adverse events, bleeding, or infections. CT bone scans were obtained for 31 patients, and the mean follow-up for CT scanning (to measure resorption and union) was 6.31 ± 1.20 months (range, 6-7.5 months). There were no cases of nonunion or partial union. Thirteen patients (42%) had no resorption, whereas 13 (42%) and 5 (16%) patents had <50% and ≥50% resorption, respectively.
Arthroscopic shoulder stabilization with distal tibial allograft reconstruction is a safe operative procedure with a minimal risk to neurovascular structures. Most patients had a healed allograft, but 16% of patients had ≥50% resorption on CT at 6 months. Studies with a longer follow-up are recommended for better assessment of the safety profile.
关节镜下前盂唇修复术在伴有明显肩胛盂骨缺损的患者中显示出较高的失败率。已开发出几种使用骨移植的重建手术来克服骨缺损。
本研究的主要目的是生成使用异体胫骨远端进行关节镜下解剖学肩胛盂重建的安全性概况。次要目的是评估接受该手术患者的影像学结果。
病例系列；证据等级，4级。
这项回顾性研究纳入了42例连续患者的病历和诊断图像，这些患者通过关节囊盂唇重新附着和异体胫骨远端骨增强进行关节镜下肩关节稳定术。通过检测术中或术后并发症来衡量安全性概况，包括神经血管（神经和血管）损伤、出血、感染和脱位。通过评估术前和术后约6个月获得的计算机断层扫描（CT）来进行影像学评估。
共纳入42例患者（29例男性，13例女性），平均年龄26.73±9.01岁。观察到良好的安全性概况，无术中并发症、神经血管损伤、不良事件、出血或感染。对31例患者进行了CT骨扫描，CT扫描（测量吸收和愈合情况）的平均随访时间为6.31±1.20个月（范围6 - 7.5个月）。无骨不连或部分愈合病例。13例患者（42%）无吸收，而13例（42%）和5例（16%）患者分别有<50%和≥50%的吸收。
异体胫骨远端移植重建关节镜下肩关节稳定术是一种安全的手术操作，对神经血管结构的风险最小。大多数患者的异体移植已愈合，但16%的患者在6个月时CT显示有≥50%的吸收。建议进行更长时间随访的研究以更好地评估安全性概况。
