Chakrabarti Moyukh O, Gwosdz James, Rosinski Alexander, Guzman Alvarho J, McGahan Patrick J, Chen James L
Advanced Orthopaedics and Sports Medicine, San Francisco, California, U.S.A.
Arthrosc Tech. 2019 May 6;8(6):e527-e533. doi: 10.1016/j.eats.2019.01.013. eCollection 2019 Jun.
Hill-Sachs lesions of the humeral head are associated with recurrent anterior shoulder instability. Arthroscopic double-pulley remplissage has emerged as the leading alternative to the open Latarjet procedure to address recurrent shoulder instability with comparable recurrence rates and favorable complication rates. This Technical Note describes our adaptation of the double-pulley remplissage technique by using 2 portals, with the anterior portal used as the viewing portal and suture passage through the posterior portal. This technique eliminates the need for a lateral percutaneous portal, consequently minimizing operative time and postoperative morbidity. Furthermore, using the anterior portal as the viewing portal allows for direct visualization of the reduction of the infraspinatus into the Hill-Sachs defect. The drawback of this technique is that there is no view of the subacromial space during knot tying.
肱骨头的希尔-萨克斯损伤与复发性肩关节前脱位相关。关节镜下双滑车充填术已成为开放性拉塔热手术的主要替代方法，用于解决复发性肩关节不稳定问题，其复发率相当，并发症发生率也较低。本技术说明描述了我们对双滑车充填技术的改良，采用两个切口，以前侧切口作为观察切口，缝线通过后侧切口。该技术无需外侧经皮切口，从而缩短了手术时间并降低了术后发病率。此外，以前侧切口作为观察切口可直接观察到冈下肌复位至希尔-萨克斯缺损处。该技术的缺点是在打结时无法观察到肩峰下间隙。
