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使用无结锚钉进行肩锁关节增强术后稳定术

Acromioclavicular Joint Augmentation Poststabilization Using Knotless Anchors.

作者信息

Zreik Nasri H, Arnander Magnus, Pearse Eyiyemi, Tennent Duncan

机构信息

Department of Orthopaedics, St. Georges University Hospitals NHS Foundation Trust, London, United Kingdom.

出版信息

Arthrosc Tech. 2024 Aug 9;14(1):103161. doi: 10.1016/j.eats.2024.103161. eCollection 2025 Jan.

DOI:10.1016/j.eats.2024.103161
PMID:39989705
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11843303/
Abstract

Acromioclavicular joint injuries are most commonly present in men aged between 20 and 40 years. Management of high-grade injuries involves reconstruction of the coracoclavicular ligaments, addressing the coronal instability of the joint. More than 100 techniques are described to manage these injuries. Reconstruction of the joint in this plane may achieve an excellent radiographic reduction; however, it may remain unstable in an anteroposterior direction (sagittal instability), resulting in ongoing symptoms. We present a 2-anchor technique that augments the acromioclavicular joint after reconstruction. It is low-profile, reproducible with on-shelf available equipment, and provides additional sagittal stability that may reduce the risk of ongoing postrecovery symptoms.

摘要

肩锁关节损伤最常见于20至40岁的男性。重度损伤的治疗包括喙锁韧带重建，以解决关节的冠状面不稳定问题。目前已有超过100种技术用于治疗这些损伤。在这个平面上重建关节可能会在影像学上实现极佳的复位；然而，它在前后方向上可能仍然不稳定（矢状面不稳定），从而导致症状持续存在。我们介绍一种双锚钉技术，该技术可在重建后增强肩锁关节。它外形小巧，使用现成的设备即可重复操作，并提供额外的矢状面稳定性，这可能会降低恢复后症状持续的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/6f3e769b0501/gr16.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/e66b14487012/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/b2c84a1ca260/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/326c8f49f4d1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/e012dccbd523/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/b027bd1e82e5/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/46835176c23c/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/f0706f370ac3/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/b4a5b736d604/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/4130aca29d12/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/878825ad3360/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/16540c5b13a5/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/889bc0c8f1ff/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/23ee5389c601/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/d41cfa46c258/gr14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/841cdfb51d0c/gr15.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/6f3e769b0501/gr16.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/e66b14487012/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/b2c84a1ca260/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/326c8f49f4d1/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/e012dccbd523/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/b027bd1e82e5/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/46835176c23c/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/f0706f370ac3/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/b4a5b736d604/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/4130aca29d12/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/878825ad3360/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/16540c5b13a5/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/889bc0c8f1ff/gr12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/23ee5389c601/gr13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/d41cfa46c258/gr14.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/841cdfb51d0c/gr15.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b8/11843303/6f3e769b0501/gr16.jpg

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本文引用的文献

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Surgical management of acute, high-grade acromioclavicular joint separations: a systematic review.急性、重度肩锁关节脱位的手术治疗：一项系统评价
JSES Rev Rep Tech. 2022 Oct 29;3(1):10-20. doi: 10.1016/j.xrrt.2022.10.002. eCollection 2023 Feb.
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Management of Acute High-Grade Acromioclavicular Joint Dislocations: Comparable Clinical and Radiological Outcomes After Bidirectional Arthroscopic-Assisted Stabilization With the Single Low-Profile Suture Button Technique Versus Double-Suture Button Technique.急性高度肩锁关节脱位的治疗：采用单低轮廓缝线纽扣技术与双缝线纽扣技术双向关节镜辅助稳定术后的临床和放射学结果比较
Arthroscopy. 2023 Nov;39(11):2283-2290. doi: 10.1016/j.arthro.2023.05.015. Epub 2023 May 23.
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Management of Acromioclavicular Injuries - Current Concepts.
肩锁关节损伤的管理——当前概念
Orthop Res Rev. 2023 Feb 16;15:1-12. doi: 10.2147/ORR.S340531. eCollection 2023.
4
Clinical and Patient-Reported Outcomes for Acute Acromioclavicular Joint Fixation are Similar With or Without Allograft Augmentation.急性肩锁关节固定术采用或不采用同种异体移植增强的临床和患者报告结局相似。
Arthrosc Sports Med Rehabil. 2022 Jul 7;4(4):e1481-e1487. doi: 10.1016/j.asmr.2022.05.010. eCollection 2022 Aug.
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The Integrity of the Acromioclavicular Capsule Ensures Physiological Centering of the Acromioclavicular Joint Under Rotational Loading.肩锁关节旋转加载下，肩锁关节囊的完整性可确保其生理中心定位。
Am J Sports Med. 2018 May;46(6):1432-1440. doi: 10.1177/0363546518758287. Epub 2018 Mar 20.
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The surgical treatment of acromioclavicular joint injuries.肩锁关节损伤的外科治疗
EFORT Open Rev. 2017 Oct 19;2(10):432-437. doi: 10.1302/2058-5241.2.160085. eCollection 2017 Oct.
7
Prevalence of remaining horizontal instability in high-grade acromioclavicular joint injuries surgically managed.手术治疗的重度肩锁关节损伤中残余水平不稳定的患病率。
Eur J Orthop Surg Traumatol. 2017 Apr;27(3):323-333. doi: 10.1007/s00590-016-1898-0. Epub 2017 Jan 5.
8
Is coracoclavicular stabilisation alone sufficient for the endoscopic treatment of severe acromioclavicular joint dislocation (Rockwood types III, IV, and V)?仅喙锁固定对于严重肩锁关节脱位（Rockwood III型、IV型和V型）的内镜治疗是否足够？
Orthop Traumatol Surg Res. 2015 Dec;101(8 Suppl):S297-303. doi: 10.1016/j.otsr.2015.09.003. Epub 2015 Oct 27.
9
Epidemiology of isolated acromioclavicular joint dislocation.孤立性肩锁关节脱位的流行病学
Emerg Med Int. 2013;2013:171609. doi: 10.1155/2013/171609. Epub 2013 Jan 28.