Wang Hong, Yang Wenbo, Meng Chunqing, Wu Shuyan, Yu Wei, Huang Wei
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Arthrosc Tech. 2024 Jan 16;13(4):102898. doi: 10.1016/j.eats.2023.102898. eCollection 2024 Apr.
The main method for arthroscopic repair of the subscapularis is repair with suture anchors. The surgeon generally establishes the anterior and anterolateral operation portals to complete anchor implantation and suture passing, respectively. The single-operation portal technique has been developed recently. However, in the traditional single-operation portal technique, the suture device and grasper are difficult to operate simultaneously. In addition, with the traditional rotator cuff suture device, it is easy to cause further iatrogenic injury to the rotator cuff because of its larger diameter. Therefore, we describe a modified single-operation portal technique for suture passing percutaneously with a spinal needle taking into account the shortcomings of existing techniques. Our modified technique avoids the use of traditional suturing devices and effectively avoids further damage to the rotator cuff. The use of a single operation portal makes the operation more minimally invasive and simple and effectively avoids the problem of interference between the suture device and grasper in the same portal. The entire operational process does not require the use of costly consumables, resulting in increased cost-effectiveness and a significantly reduced operating time. In conclusion, our modified technique achieves the use of a single operation portal to suture the subscapularis through spinal needle suture passing, which has good clinical value.
肩胛下肌关节镜修复的主要方法是使用缝合锚钉进行修复。外科医生通常分别建立前侧和前外侧手术入路，以完成锚钉植入和缝线穿过。单操作入路技术是最近发展起来的。然而，在传统的单操作入路技术中，缝合装置和抓持器难以同时操作。此外，使用传统的肩袖缝合装置时，由于其直径较大，容易对肩袖造成进一步的医源性损伤。因此，考虑到现有技术的缺点，我们描述了一种改良的单操作入路技术，即使用脊椎穿刺针经皮穿过缝线。我们改良的技术避免了使用传统的缝合装置，并有效避免了对肩袖的进一步损伤。使用单一手术入路使手术更微创、更简单，并有效避免了同一入路中缝合装置和抓持器相互干扰的问题。整个手术过程不需要使用昂贵的耗材，从而提高了成本效益并显著缩短了手术时间。总之，我们改良的技术实现了通过脊椎穿刺针缝线穿过，使用单一手术入路缝合肩胛下肌，具有良好的临床价值。
