de Campos Azevedo Clara I, Ângelo Ana Catarina
Shoulder and Elbow Unit, Department of Orthopaedic Surgery, Hospital dos SAMS de Lisboa, Lisbon, Portugal.
Shoulder and Elbow Unit, Orthopaedic and Musculoskeletal Centre, Cuf Tejo Hospital, Lisbon, Portugal.
Arthrosc Tech. 2023 Jun 12;12(7):e1097-e1106. doi: 10.1016/j.eats.2023.02.048. eCollection 2023 Jul.
The treatment of anterior glenohumeral instability includes several surgical options, ranging from soft tissue to bony procedures-open or arthroscopic. In arthroscopic dynamic anterior stabilization (DAS) of the shoulder, the long head of the biceps is transferred to the anterior glenoid through a subscapularis tendon split. The biceps may be fixed either in an inlay or in an onlay position. Inlay DAS theoretically increases anterior glenohumeral stability through 3 different effects: the hammock effect, sling effect, and the tensioning effect. Onlay DAS may additionally increase stability through a labroplasty effect, produced by the onlay positioning of the biceps on the anterior glenoid rim. The current technical note presents tips and tricks, and pearls and pitfalls, to reproducibly perform onlay DAS using all-suture anchors and the double double-pulley technique.
肩肱关节前侧不稳定的治疗包括多种手术选择，范围从软组织手术到开放性或关节镜下的骨性手术。在肩关节镜下动态前侧稳定术（DAS）中，肱二头肌长头通过肩胛下肌腱劈开转移至关节盂前部。肱二头肌可固定于嵌体或覆盖位置。理论上，嵌体式DAS通过三种不同作用增强肩肱关节前侧稳定性：吊床效应、吊带效应和张紧效应。覆盖式DAS还可通过肱二头肌在关节盂前部边缘的覆盖定位产生的盂唇成形术效应增加稳定性。本技术说明介绍了使用全缝线锚钉和双滑轮技术可重复性地进行覆盖式DAS的技巧、窍门、要点及陷阱。
