Apostolakos John M, Wright-Chisem Joshua, Gulotta Lawrence V, Taylor Samuel A, Dines Joshua S
Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, NY 10021, United States.
World J Orthop. 2021 Jan 18;12(1):1-13. doi: 10.5312/wjo.v12.i1.1.
The glenohumeral joint (GHJ) allows for a wide range of motion, but is also particularly vulnerable to episodes of instability. Anterior GHJ instability is especially frequent among young, athletic populations during contact sporting events. Many first time dislocators can be managed non-operatively with a period of immobilization and rehabilitation, however certain patient populations are at higher risk for recurrent instability and may require surgical intervention for adequate stabilization. Determination of the optimal treatment strategy should be made on a case-by-case basis while weighing both patient specific factors and injury patterns (, bone loss). The purpose of this review is to describe the relevant anatomical stabilizers of the GHJ, risk factors for recurrent instability including bony lesions, indications for arthroscopic open surgical management, clinical history and physical examination techniques, imaging modalities, and pearls/pitfalls of arthroscopic soft-tissue stabilization for anterior glenohumeral instability.
肩关节（GHJ）允许广泛的运动，但也特别容易出现不稳定情况。前GHJ不稳定在年轻的运动员群体中，在接触性体育赛事期间尤为常见。许多首次脱位者可以通过一段时间的固定和康复进行非手术治疗，然而某些患者群体复发性不稳定的风险较高，可能需要手术干预以实现充分的稳定。在权衡患者特定因素和损伤模式（如骨质流失）时，应根据具体情况确定最佳治疗策略。本综述的目的是描述GHJ的相关解剖稳定结构、复发性不稳定的风险因素（包括骨病变）、关节镜/开放手术治疗的适应症、临床病史和体格检查技术、成像方式以及前肩关节不稳定关节镜软组织稳定的要点/陷阱。
