Jos Sujit, Sanu Shankar, J Antony, Thomas M Libin, Paulose Bobby
Institute of Advanced Orthopedics, MOSC Medical College Hospital, Kolenchery, Ernakulam, Kerala, India.
Arthrosc Tech. 2022 Jun 21;11(7):e1277-e1287. doi: 10.1016/j.eats.2022.03.011. eCollection 2022 Jul.
Arthroscopic Latarjet has evolved as a reproducible procedure to address significant anterior glenoid bone loss in recurrent anterior instability of the shoulder joint. While arthroscopic Bankart procedure for anterior shoulder instability has changed from metal anchors to absorbable or soft all-suture anchors to avoid metal-ware and subsequent abrasion in cases of osteolysis or backout, Latarjet procedure, until recently couple of titanium screws were used to fix the coracoid bone to the anterior glenoid. Arthroscopic techniques for Latarjet procedure of coracoid bone transfer have shown results similar to the open technique in many recent studies. We use an all-arthroscopic technique that is different and easier from the currently described technique using FiberTape cerclage loops, with 2 ultrabraid tapes fixing the coracoid bone to the prepared anteroinferior glenoid surface. The repair is completed using all-suture anchors to fix the anterior capsule over the attached coracoid, thus exteriorizing the transferred bone and preventing contact with the moving humeral head.
关节镜下Latarjet手术已发展成为一种可重复的手术方法,用于解决复发性肩关节前脱位中严重的肩胛盂前骨缺损问题。虽然用于治疗肩关节前脱位的关节镜下Bankart手术已从金属锚钉改为可吸收或全缝线锚钉,以避免在骨质溶解或锚钉退出的情况下出现金属器械及随后的磨损,但直到最近,Latarjet手术仍使用几枚钛螺钉将喙突骨固定于肩胛盂前部。在许多近期研究中,关节镜下喙突骨转移Latarjet手术技术显示出与开放手术相似的结果。我们采用一种全关节镜技术,该技术与目前描述的使用FiberTape环扎带的技术不同且更简便,使用2根超编织带将喙突骨固定于准备好的肩胛盂前下表面。使用全缝线锚钉将前关节囊固定于附着的喙突上,从而使转移的骨块外置并防止其与活动的肱骨头接触,完成修复。