Boileau Pascal, Jettoo Prithee, Lacouture Juan-David
ICR - Institut de Chirurgie Réparatrice Locomoteur & Sport, Groupe Kantys, Nice, France.
Arthrosc Tech. 2023 May 15;12(6):e923-e930. doi: 10.1016/j.eats.2023.02.028. eCollection 2023 Jun.
Recurrence of anterior instability after a Latarjet procedure with persistent glenoid bone loss can be related to coracoid bone block resorption, migration, or malposition. Multiple options are available to address anterior glenoid bone loss, including autograft bone transfers (such as iliac crest graft, distal clavicle autograft) or allografts (distal tibia allograft). Here, we present the use of the remnant coracoid process as an option for consideration in the treatment of glenoid bone loss after failed Latarjet procedure with persistent glenoid bone loss. The remnant coracoid autograft is harvested and transferred inside the glenohumeral joint, through the rotator interval, and fixed using cortical buttons. This arthroscopic procedure includes using 1) glenoid and coracoid drilling guides to optimize graft positioning and making the procedure more reproducible and safer and 2) a suture tensioning device to provide intraoperative graft compression and ensure bone graft healing.
在Latarjet手术且存在持续性肩胛盂骨缺损后出现前方不稳定复发，可能与喙突骨块吸收、移位或位置不良有关。有多种方法可用于解决肩胛盂前方骨缺损问题，包括自体骨移植（如髂嵴移植、锁骨远端自体移植）或同种异体移植（胫骨远端同种异体移植）。在此，我们介绍使用残留喙突作为一种可供考虑的选择，用于治疗Latarjet手术失败且存在持续性肩胛盂骨缺损后的肩胛盂骨缺损。将残留喙突自体骨取出，经旋转间隙转移至盂肱关节内，并用皮质纽扣固定。这种关节镜手术包括使用1）肩胛盂和喙突钻孔导向器以优化移植物定位，使手术更具可重复性和安全性，以及2）缝线张紧装置以在术中对移植物进行加压并确保骨移植愈合。
