Schlüßler Antonia, Martinez-Ulloa Aaron, Moroder Philipp, Scheibel Markus
Schulthess Clinic, Zurich, Switzerland.
University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
Arthrosc Tech. 2024 Feb 19;13(5):102933. doi: 10.1016/j.eats.2024.102933. eCollection 2024 May.
Posterior bone grafting represents an emerging therapeutic approach for addressing recurrent instability in the posterior shoulder, particularly when coupled with substantial glenoid bone loss. Although not as prevalent as anterior instability, recent years have witnessed the development of numerous open and arthroscopic bony reconstruction methods. A technical gold standard for posterior bone grafting remains undefined, leading to ongoing advancements in bone grafting techniques. In response to past challenges associated with screw fixation, metal-free arthroscopic fixation procedures have been introduced to the realm of bone grafting. These metal-free methods often entail intricate transglenoid drilling, which poses potential surgical complexities and risks to both posterior and anterior soft tissues, as well as neurovascular structures. Therefore, we introduce an arthroscopic approach to posterior bone grafting using PEEK (polyether ether ketone) anchors with interconnected sutures and a scapular spine autograft. This method overcomes previous hurdles by facilitating the restoration of the posterior glenoid bone stock with precise positioning and secure fixation of the tricortical scapular spine bone autograft.
后路植骨是一种新兴的治疗方法，用于解决后肩部复发性不稳定问题，尤其是在合并严重肩胛盂骨缺损时。虽然不如前向不稳定那么常见，但近年来已经出现了许多开放和关节镜下的骨重建方法。后路植骨的技术金标准尚未明确，这导致植骨技术不断进步。为应对过去与螺钉固定相关的挑战，无金属关节镜固定手术已被引入植骨领域。这些无金属方法通常需要复杂的经肩胛盂钻孔，这对前后软组织以及神经血管结构都带来了潜在的手术复杂性和风险。因此，我们介绍一种使用聚醚醚酮（PEEK）锚钉和相互连接的缝线以及肩胛冈自体骨移植的关节镜下后路植骨方法。该方法通过精确放置和牢固固定三皮质肩胛冈自体骨移植来促进肩胛盂骨量的恢复，从而克服了以往的障碍。
