Department of Orthopaedics and Traumatology, Yeditepe University, School of Medicine, İstanbul, Turkey.
Department of Anatomy, Dokuz Eylül University, School of Medicine, İzmir, Turkey.
Acta Orthop Traumatol Turc. 2021 Jan;55(1):38-41. doi: 10.5152/j.aott.2021.19197.
This study aims to investigate the anatomical relationships of the transmuscular portal to its surrounding structures in arthroscopic treatment of superior labrum anterior posterior (SLAP) lesions in a human cadaveric model.
In this anatomic study, bilateral shoulder girdles of 12 adult formalin embalmed cadavers were used. All cadavers were male, and the mean age was 63.4±7.3 years. The portal entry point was determined as midway between the anterior and posterior borders of the acromion, approximately 1 cm lateral from the edge of the acromion. After a guidewire was placed in the glenoid cavity at the 12 o'clock position where the SLAP lesion typically occurs, a switching stick was inserted there. Each glenoid was then drilled with a 2.4 mm drill through an arthroscopic cannula. Subsequently, anatomical dissection was executed to assess the relationship of the transmuscular portal with the suprascapular nerve, axillary nerve, supraspinatus tendon, acromion, and biceps tendon. Lastly, the shortest distance between the aforementioned structures with the drill was measured by a sensitive caliper to determine whether there was a penetration of the structures. Differences between the right and left sides were analyzed.
The mean distance between the portal and the axillary nerve was 55.5 mm±6.0 mm, and the mean length of the suprascapular nerve was 61.2 mm±7.0 mm. The mean distance between the portal and the supraspinatus tendon was 2.8 mm±1.5 mm. No penetration of the axillary nerve, suprascapular nerve, and supraspinatus tendon was observed in any cadaver. No differences were detected for measured anatomical parameters between the right and left sides (p>0.05).
Findings from this cadaveric study revealed that the transmuscular portal may allow for a reliable anchor placement without any nerve or tendon penetration during arthroscopic SLAP repair.
Level V.
本研究旨在通过人体尸体模型，研究关节镜治疗前上盂唇前后损伤（SLAP）病变时经肌肉入路关节盂入口与周围结构的解剖关系。
本解剖学研究使用了 12 具男性福尔马林防腐固定的成人尸体双侧肩带，平均年龄 63.4±7.3 岁。将入口点确定为肩峰前、后缘的中点，距肩峰边缘约 1cm 处。在关节镜套管内将导丝置于通常发生 SLAP 病变的 12 点钟位置的关节盂腔中，然后将转换棒插入其中。然后用 2.4mm 钻头经关节镜套管在每个关节盂上钻孔。随后进行解剖以评估经肌肉入路与肩胛上神经、腋神经、冈上肌腱、肩峰和肱二头肌肌腱的关系。最后，用灵敏的卡尺测量上述结构与钻头之间的最短距离，以确定是否有结构穿透。分析左右两侧的差异。
入口与腋神经之间的平均距离为 55.5mm±6.0mm，肩胛上神经的平均长度为 61.2mm±7.0mm。入口与冈上肌腱之间的平均距离为 2.8mm±1.5mm。在任何一具尸体中，均未观察到腋神经、肩胛上神经和冈上肌腱穿透。左右两侧测量的解剖学参数无差异（p>0.05）。
这项尸体研究的结果表明，在关节镜 SLAP 修复过程中，经肌肉入路可能允许可靠地放置锚钉，而不会穿透神经或肌腱。
5 级。
