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肩胛下肌吊带手术治疗前肩不稳的动态与静态稳定作用

Dynamic and Static Stabilization of Anterior Shoulder Instability With the Subscapular Sling Procedure.

作者信息

Klungsøyr Jan Arild, Vagstad Terje, Klungsøyr Peter Johannes, Hellevik Alf Inge, Drogset Jon Olav

机构信息

Norwegian University of Science and Technology (NTNU), Faculty of Medicine and Health Sciences, Trondheim, Norway.

Department of Orthopaedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway.

出版信息

Arthrosc Tech. 2021 Jun 20;10(7):e1773-e1781. doi: 10.1016/j.eats.2021.03.027. eCollection 2021 Jul.

Abstract

There are numerous arthroscopic techniques available to address anterior shoulder instability. Complications are various, and in pursuit of new treatment options, an alternative arthroscopic technique with less potential for complications has been developed. The novel subscapular sling with a semitendinosus graft provides both dynamic and static stability. This procedure uses a semitendinosus graft as a sling around the upper two-thirds of the subscapular tendon, attached to the anterior glenoid rim. The sling phenomenon present in the Latarjet procedure was the basis of the development. The efficacy of the subscapular sling procedure has been verified in biomechanical studies and further investigated in a clinical pilot study. The procedure can be performed without altering the anatomy of nearby structures such as the coracoid process, the conjoined tendon, and the axillary and musculocutaneous nerves. The authors propose the arthroscopic subscapular sling procedure as an alternative to existing surgical treatment options for recurrent anterior shoulder instability.

摘要

有多种关节镜技术可用于治疗肩关节前向不稳。并发症多种多样,为了寻求新的治疗选择,已开发出一种并发症可能性较小的替代关节镜技术。带有半腱肌移植物的新型肩胛下肌吊带可提供动态和静态稳定性。该手术使用半腱肌移植物作为围绕肩胛下肌腱上三分之二的吊带,附着于肩胛盂前缘。Latarjet手术中出现的吊带现象是该技术发展的基础。肩胛下肌吊带手术的疗效已在生物力学研究中得到验证,并在一项临床初步研究中作了进一步调查。该手术可以在不改变附近结构如喙突、联合肌腱以及腋神经和肌皮神经解剖结构的情况下进行。作者提出关节镜下肩胛下肌吊带手术可作为复发性肩关节前向不稳现有手术治疗选择的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d60/8322630/59d4d888484f/gr1.jpg

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