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在肩关节270°盂唇撕裂情况下使用无结缝线锚钉进行关节镜下盂唇修复术

Arthroscopic Labral Repair Using Knotless Suture Anchors in the Setting of a 270° Labral Tear of the Shoulder.

作者信息

Comfort Spencer M, Peebles Annalise M, Ruzbarsky Joseph J, Akamefula Ramesses A, Provencher Matthew T

机构信息

Steadman Philippon Research Institute, Vail, Colorado, United States.

The Steadman Clinic, Vail, Colorado, United States.

出版信息

Arthrosc Tech. 2021 Sep 21;10(10):e2319-e2324. doi: 10.1016/j.eats.2021.07.037. eCollection 2021 Oct.

Abstract

Extensive glenoid labral tears, whether the result of repetitive instability or first-time dislocation, compromise the mechanical stability of the glenohumeral joint due to disruption of the anterior, inferior, posterior, and/or superior portions of the labrum. These lesions often result in recurrent multiplanar instability and pain that is nonresponsive to conservative management and difficult to diagnose due to variability in clinical presentation and advanced imaging findings. Arthroscopic repair techniques to address symptomatic shoulder instability have showed positive patient-reported outcomes, low failure rates, and high return-to-sport rates. The evolution of knotless suture anchors offers a fixation method that has proven to be functionally equivalent to knotted suture anchors while avoiding the risks of knotted anchors (knot loosening, knot migration, articular abrasion) and allowing easier placement and decreased operative time. The purpose of this technique is to describe our preferred method to treat a 270° labral tear through arthroscopic knotless anchor repair and demonstrate the expanded application of this technique for extensive glenoid labral pathology.

摘要

广泛的盂唇撕裂,无论是反复不稳定还是首次脱位的结果,都会因盂唇前、下、后和/或上部分的破坏而损害盂肱关节的机械稳定性。这些损伤常导致复发性多平面不稳定和疼痛,对保守治疗无反应,且由于临床表现和先进影像学表现的变异性而难以诊断。用于解决有症状的肩部不稳定的关节镜修复技术已显示出良好的患者报告结果、低失败率和高重返运动率。无结缝线锚钉的发展提供了一种固定方法,已证明其在功能上等同于有结缝线锚钉,同时避免了有结锚钉的风险(结松动、结移位、关节磨损),并使放置更容易且手术时间缩短。本技术的目的是描述我们通过关节镜无结锚钉修复治疗270°盂唇撕裂的首选方法,并展示该技术在广泛的盂唇病变中的扩展应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d5f/8556671/721d928b44cf/gr1.jpg

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