Arthroscopy. 2022 Jun;38(6):1772-1773. doi: 10.1016/j.arthro.2022.01.032.
A nuanced approach to treatment of anterior shoulder instability is encouraged, particularly in patients with subcritical glenoid bone loss. In patients with bone loss, recurrent instability after isolated arthroscopic Bankart repair has dampened enthusiasm for this procedure. Adjunctive treatment with remplissage or dynamic anterior stabilization via biceps tenodesis to the glenoid is an alternative to bone transfer procedures, which are effective but have higher complication rates. Dynamic anterior stabilization or tenodesis of the long head of the biceps to the 3-o'clock position on the glenoid through a subscapularis split is biomechanically superior to isolated Bankart repair for reducing anterior translation, even in the setting of minor glenoid bone loss due to a sling effect similar to that produced by the Latarjet procedure. A disadvantage is placement of a large implant into the small space of the anterior glenoid and creation of a soft-tissue defect in the capsule.
鼓励对前肩不稳定采用细致入微的治疗方法，特别是在有亚临界肩胛盂骨丢失的患者中。在有骨丢失的患者中，孤立的关节镜 Bankart 修复后反复出现不稳定，降低了对该手术的热情。用填充或通过二头肌肌腱固定术向肩胛盂施加动态前稳定作为骨转移手术的替代方法，这些方法有效，但并发症发生率更高。通过肩胛下肌劈开将二头肌长头动态或经皮固定至肩胛盂 3 点钟位置，在减少前向平移方面优于孤立的 Bankart 修复，即使在由于吊带效应导致的轻微肩胛盂骨丢失的情况下也是如此，这种吊带效应类似于 Latarjet 手术产生的效应。缺点是将大植入物放入前肩胛盂的小空间中，并在囊内形成软组织缺损。
