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使用同侧膝关节的自体骨软骨移植技术重建中央全层关节盂缺损。

Reconstruction of a Central Full-Thickness Glenoid Defect Using Osteochondral Autograft Technique from the Ipsilateral Knee.

作者信息

Junker Marius, Kircher Jörn

机构信息

Orthopedic University Hospital Friedrichsheim, Marienburgstraße 2, 60528 Frankfurt, Germany.

Department of Shoulder and Elbow Surgery, ATOS Klinik Fleetinsel Hamburg, Hamburg, Germany.

出版信息

Indian J Orthop. 2020 Aug 30;54(Suppl 1):25-26. doi: 10.1007/s43465-020-00190-8. eCollection 2020 Sep.

Abstract

BACKGROUND

Osteochondral defects (OCDs) of the shoulder represent a typical clinical problem and are difficult to manage. OCDs of the upper extremity are less common than those of the lower extremity. The incidence is reported to be between 5-17% in which the humerus is affected more frequently than the glenoid. OCD is often accompanied with symptoms and may appear secondary to trauma, instability or prior operation. The problem of the lesions is the missing blood circulation which makes the healing impossible. The hazard of OCDs is the progression to osteoarthritis. In spite of the effectiveness of total shoulder arthroplasty it is not the first option for young and active patients. The therapy options of OCD depend on the size and localization of the defect.

PURPOSE

The aim of this multimedia article is to reveal a therapy option for OCDs of the glenoid.

METHODS

In this case we present the reconstruction of a central full-thickness osteochondral glenoid defect with an osteochondral autograft from the ipsilateral knee which was withdrawn using the OATS-Technique (Arthrex, Naples, Florida) to address the chondral as well as the osseous pathology. To the best of our knowledge there has been no such procedure performed and described so far.

RESULTS

The procedure lead to proper restoration of the defect.

CONCLUSION

The demonstrated technique can be used to perform the reconstruction of a full-thickness osteochondral glenoid defect.

摘要

背景

肩关节骨软骨损伤(OCDs)是典型的临床问题,治疗困难。上肢的OCDs比下肢少见。据报道,发病率在5%至17%之间,其中肱骨比肩胛盂更易受累。OCD常伴有症状,可能继发于创伤、不稳定或既往手术。病变的问题是缺乏血液循环,导致无法愈合。OCDs的危害是进展为骨关节炎。尽管全肩关节置换术有效,但对于年轻活跃的患者而言并非首选。OCDs的治疗方案取决于缺损的大小和位置。

目的

本文献的目的是揭示一种治疗肩胛盂OCDs的方案。

方法

在此病例中,我们展示了使用OATS技术(Arthrex,佛罗里达州那不勒斯)取自同侧膝关节的骨软骨自体移植修复中央全层肩胛盂骨软骨缺损,以解决软骨及骨质病变。据我们所知,目前尚未有此类手术实施及报道。

结果

该手术使缺损得到妥善修复。

结论

所展示的技术可用于全层肩胛盂骨软骨缺损的重建。

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本文引用的文献

1
Management of cartilage defects in the shoulder.肩部软骨缺损的处理。
Curr Rev Musculoskelet Med. 2012 Sep;5(3):254-62. doi: 10.1007/s12178-012-9131-1.

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