Aramberri Mikel, Tiso Giovanni, Haeni David L
Ramón y Cajal Teaching Hospital, Madrid, Spain.
Alai Sports Medicine Clinic, Madrid, Spain.
Arthrosc Tech. 2018 Feb 26;7(3):e279-e283. doi: 10.1016/j.eats.2017.09.007. eCollection 2018 Mar.
Synovial chondromatosis of the shoulder is a rare disorder characterized by metaplastic synovial proliferation, causing multiple loose bodies usually localized intra-articularly. Surgical treatment with open techniques through a deltopectoral approach has been commonly used. The evolution of arthroscopy has allowed a complete joint assessment and the extraction of intra-articular loose bodies with less morbidity than open techniques. Nevertheless, this pathology occurs less frequently in the subcoracoid bursa. Access to this bursa may be more complicated when extracting loose bodies that cause pain and functional limitation in performing activities of daily living. We describe an arthroscopic and endoscopic technique for the treatment of subcoracoid synovial chondromatosis through a medial transpectoral portal, allowing safe loose body extraction under direct visualization around the coracoid process and brachial plexus. The literature was reviewed, and benefits of this endoscopic technique were analyzed.
肩部滑膜软骨瘤病是一种罕见的疾病,其特征为化生的滑膜增生,导致多个通常局限于关节内的游离体。通过三角肌胸大肌入路的开放技术进行手术治疗一直是常用方法。关节镜技术的发展使得能够对关节进行全面评估,并以比开放技术更低的发病率取出关节内游离体。然而,这种病变在喙突下囊较少见。当取出导致日常生活活动中疼痛和功能受限的游离体时,进入该囊可能会更复杂。我们描述了一种通过内侧经胸壁入路治疗喙突下滑膜软骨瘤病的关节镜和内镜技术,该技术可在喙突和臂丛神经周围直接可视化的情况下安全取出游离体。我们回顾了相关文献,并分析了这种内镜技术的优势。