Alrabaa Rami G, Padaki Ajay S, Vijittrakarnrung Chaiyanun, Lansdown Drew A, Kandemir Utku, Tangtiphaiboontana Jennifer
Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, California, U.S.A.
Arthrosc Tech. 2022 Dec 21;12(1):e53-e57. doi: 10.1016/j.eats.2022.08.057. eCollection 2023 Jan.
Glenohumeral instability causing bipolar bone loss is increasingly being recognized and treated to minimize recurrence. Large Hill-Sachs and reverse Hill-Sachs lesions of the humerus must be addressed at the time of surgery to prevent recurrent dislocations and restore the native anatomic track. For patients with epilepsy, locked dislocations may create defects that must be addressed with bony procedures, including osteochondral allograft reconstruction as soft-tissue remplissage may not adequately addresses the magnitude of the bone loss. Osteochondral allografts have been successfully used to address bony defects ranging from 20% to 30% of humeral bone loss whereas shoulder arthroplasty is indicated for larger defects where the native anatomy can no longer be restored. In this Technical Note, we present a technique to address concomitant large Hill-Sachs and reverse Hill-Sachs lesions.
越来越多的人认识到并开始治疗导致双极骨质流失的肩肱关节不稳，以尽量减少复发。手术时必须处理肱骨的大型希尔-萨克斯损伤和反希尔-萨克斯损伤，以防止复发性脱位并恢复自然解剖轨迹。对于癫痫患者，锁定脱位可能会造成必须通过骨手术来解决的缺损，包括异体骨软骨移植重建，因为软组织填充可能无法充分解决骨质流失的程度。异体骨软骨移植已成功用于解决肱骨骨质流失20%至30%的骨缺损，而肩关节置换术适用于无法再恢复自然解剖结构的较大缺损。在本技术说明中，我们介绍一种处理同时存在的大型希尔-萨克斯损伤和反希尔-萨克斯损伤的技术。
