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盲式打结填充法：技术与步骤

Blind-Tie Remplissage: Technique and Sequence.

作者信息

Gentry Weston B, Field Larry D

机构信息

Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, U.S.A.

出版信息

Arthrosc Tech. 2024 Aug 27;14(1):103168. doi: 10.1016/j.eats.2024.103168. eCollection 2025 Jan.

DOI:10.1016/j.eats.2024.103168
PMID:39989696
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11843316/
Abstract

Patients with recurrent anterior shoulder instability and an associated Hill-Sachs lesion are commonly encountered by orthopaedic surgeons. Effective management of the Hill-Sachs lesion can be performed using an arthroscopic remplissage technique to fill the bony defect with the infraspinatus and posterior capsule. Various surgical techniques, anchor configurations, and tying mechanisms can be used to accomplish the remplissage procedure. The goal of this Technical Note is to describe our technique and sequence for accomplishing an arthroscopic "blind-tie" remplissage procedure. In this remplissage technique, the suture anchor sutures placed into the Hill-Sachs defect are tied in a blind fashion over the infraspinatus fascia without direct visualization from within the subacromial space.

摘要

骨科医生经常会遇到复发性肩关节前脱位并伴有Hill-Sachs损伤的患者。对于Hill-Sachs损伤，可采用关节镜下填充技术，利用冈下肌和后关节囊填充骨缺损，从而实现有效治疗。完成填充手术可采用多种手术技术、锚钉配置和打结方法。本技术说明的目的是描述我们完成关节镜下“盲打”填充手术的技术和步骤。在这种填充技术中，置于Hill-Sachs缺损处的缝线锚钉缝线在冈下肌筋膜上方以盲打方式打结，无需在肩峰下间隙内直接观察。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/000dfd5d6a99/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/9f2b5050a4de/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/8e1ca2260fb7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/9509a5238f20/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/f363ae2a4c89/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/a62c32eeabbe/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/fa982df41ac5/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/d97eee011eb6/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/5b30b35390ba/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/d8af358c6634/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/000dfd5d6a99/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/9f2b5050a4de/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/8e1ca2260fb7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/9509a5238f20/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/f363ae2a4c89/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/a62c32eeabbe/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/fa982df41ac5/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/d97eee011eb6/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/5b30b35390ba/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/d8af358c6634/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd5d/11843316/000dfd5d6a99/gr10.jpg

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本文引用的文献

1
Epidemiology of shoulder dislocations presenting to United States emergency departments: An updated ten-year study.美国急诊科肩关节脱位的流行病学：一项更新的十年研究。
World J Orthop. 2023 Sep 18;14(9):690-697. doi: 10.5312/wjo.v14.i9.690.
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Increased Risk of Fracture, Dislocation, and Hospitalization Are Associated With Collision in Contact Sports.接触性运动中的碰撞与骨折、脱位及住院风险增加相关。
Arthrosc Sports Med Rehabil. 2023 Jul 26;5(5):100781. doi: 10.1016/j.asmr.2023.100781. eCollection 2023 Oct.
3
Remplissage reduces recurrent instability in high-risk patients with on-track Hill-Sachs lesions.
填充术降低高危患者有轨道 Hill-Sachs 损伤的复发性不稳定。
J Shoulder Elbow Surg. 2023 Jun;32(6S):S99-S105. doi: 10.1016/j.jse.2023.02.011. Epub 2023 Feb 23.
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Return to Sport After Arthroscopic Bankart Repair With Remplissage: A Systematic Review.关节镜下Bankart修复联合Remplissage术后恢复运动：一项系统评价
Arthroscopy. 2023 Apr;39(4):1046-1059.e3. doi: 10.1016/j.arthro.2022.12.032. Epub 2023 Jan 13.
5
Arthroscopic Remplissage Combined With Bankart Repair Results in a Higher Rate of Return to Sport in Athletes Compared With Bankart Repair Alone or the Latarjet Procedure: A Systematic Review and Meta-analysis.关节镜下填充联合 Bankart 修复术与 Bankart 修复术或 Latarjet 术相比，运动员重返运动的比例更高：系统评价和荟萃分析。
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Clinical outcomes and recurrence rate of 4 procedures for recurrent anterior shoulder instability: ASA, remplissage, open, and arthroscopic Latarjet: a multicenter study.复发性前肩不稳的四种手术（关节镜下缝线桥固定术、Remplissage手术、开放Latarjet手术和关节镜下Latarjet手术）的临床结果和复发率：一项多中心研究
J Shoulder Elbow Surg. 2023 May;32(5):931-938. doi: 10.1016/j.jse.2022.10.030. Epub 2022 Dec 5.
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Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate.关节镜下Bankart修复和Remplissage手术治疗伴亚临界骨丢失的前下不稳，复发率低。
Arthrosc Sports Med Rehabil. 2022 Feb 1;4(2):e695-e703. doi: 10.1016/j.asmr.2021.12.014. eCollection 2022 Apr.
8
Remplissage Yields Similar 2-Year Outcomes, Fewer Complications, and Low Recurrence Compared to Latarjet Across a Wide Range of Preoperative Glenoid Bone Loss.在广泛的术前肩胛盂骨丢失范围内，填充物的 2 年结果相似，并发症更少，复发率低，与 Latarjet 相比。
Arthroscopy. 2022 Oct;38(10):2798-2805. doi: 10.1016/j.arthro.2022.03.031. Epub 2022 Apr 8.
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Recurrence in traumatic anterior shoulder dislocations increases the prevalence of Hill-Sachs and Bankart lesions: a systematic review and meta-analysis.创伤性前肩脱位的复发会增加 Hill-Sachs 和 Bankart 病变的发生率：系统评价和荟萃分析。
Knee Surg Sports Traumatol Arthrosc. 2022 Jun;30(6):2130-2140. doi: 10.1007/s00167-021-06847-7. Epub 2022 Jan 6.
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Surgical treatment of anterior shoulder instability with glenoid bone loss with the Latarjet procedure in active-duty military service members.现役军人伴发盂骨缺损的复发性肩关节前脱位的 Latarjet 手术治疗。
J Shoulder Elbow Surg. 2022 Mar;31(3):629-633. doi: 10.1016/j.jse.2021.08.015. Epub 2021 Sep 16.