White Alex E, Patel Nirav K, Hadley Christopher J, Dodson Christopher C
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA (Mr. White); VCU Health, Medical College of Virginia at Virginia Commonwealth University, Richmond, VA (Dr. Patel); and The Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA (Mr. Hadley and Dr. Dodson).
J Am Acad Orthop Surg Glob Res Rev. 2019 Dec 23;3(12). doi: 10.5435/JAAOSGlobal-D-19-00168. eCollection 2019 Dec.
The recurrence of anterior shoulder instability can be as high as 86.7% in high-risk patients who are treated nonoperatively after their first incident of instability. CT and MR arthrography are necessary for preoperative imaging and assessment of glenoid bone loss. Patient expectations in conjunction with appropriate preoperative imaging are critical for surgical planning. Arthroscopic shoulder stabilization is often sufficient in most cases where glenoid bone loss is minimal, with recurrent dislocation rates close to 4% in the literature. Open stabilization procedures are generally indicated in patients with greater than 20% glenoid bone loss.
首次出现肩关节不稳定事件后接受非手术治疗的高危患者，其肩关节前侧不稳定的复发率可能高达86.7%。CT和磁共振关节造影对于术前评估肩胛盂骨质流失情况及成像很有必要。患者的期望与适当的术前成像相结合对于手术规划至关重要。在大多数肩胛盂骨质流失极少的病例中，关节镜下肩关节稳定术通常就足够了，文献报道其复发性脱位率接近4%。对于肩胛盂骨质流失超过20%的患者，一般建议采用开放稳定手术。
