Levin Jay M, Whitlock Keith G, Warren Eric, Klifto Christopher S, Anakwenze Oke
Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A.
Arthrosc Tech. 2023 May 11;12(6):e787-e794. doi: 10.1016/j.eats.2023.02.055. eCollection 2023 Jun.
Arthroscopic distal clavicle autograft represents a locally available source of autograft for bone block augmentation in patients with anterior shoulder instability with glenoid bone loss. Anatomic and biomechanical studies have supported distal clavicle autograft use as comparable to coracoid graft with regard to restoration of glenoid articular surface, with the theoretical advantage of minimizing complications associated with coracoid transfer procedures, such as neurologic injury and coracoid fracture. The current technique describes a modification of those previously described, including a mini-open approach for distal clavicle autograft harvest, orientation of the distal clavicle with the medial clavicle graft against the glenoid (congruent arc), an all-arthroscopic technique of graft passage, and graft placement and fixation using specialized drill guides and four suture buttons to reproducibly place and secure the graft with final capsulolabral advancement over the graft to render it extra-articular.
关节镜下锁骨远端自体移植是一种局部可用的自体移植来源，用于有肩胛盂骨丢失的前肩不稳患者的骨块增强。解剖学和生物力学研究支持使用锁骨远端自体移植，在恢复肩胛盂关节面方面与喙突移植相当，理论上的优势是将与喙突转移手术相关的并发症（如神经损伤和喙突骨折）降至最低。当前技术描述了对先前所述技术的改进，包括锁骨远端自体移植获取的迷你切开入路、将锁骨远端与内侧锁骨移植物以与肩胛盂相对（一致弧）的方式定向、移植物通过的全关节镜技术，以及使用专门的钻孔导向器和四个缝线纽扣进行移植物放置和固定，以可重复的方式放置和固定移植物，最后通过关节囊盂唇推进覆盖移植物使其位于关节外。
