Huri Gazi, Popescu Ion-Andrei, Rinaldi Vito Gaetano, Marcheggiani Muccioli Giulio Maria
Aspetar, FIFA Medical Center of Excellence, Doha 29222, Qatar.
Department of Orthopaedics and Traumatology, Hacettepe University, 06800 Ankara, Türkiye.
J Clin Med. 2025 Apr 1;14(7):2405. doi: 10.3390/jcm14072405.
Arthroscopic shoulder surgery has undergone significant advancements over the past decades, transitioning from a primarily diagnostic tool to a comprehensive therapeutic approach. Technological innovations and refined surgical techniques have expanded the indications for arthroscopy, allowing minimally invasive management of shoulder instability and rotator cuff pathology. : This narrative review explores the historical evolution, current trends, and future perspectives in arthroscopic shoulder surgery. : Key advancements in shoulder instability management include the evolution of the arthroscopic Bankart repair, the introduction of the remplissage technique for Hill-Sachs lesions, and the development of arthroscopic Latarjet procedures. Additionally, novel techniques such as Dynamic Anterior Stabilization (DAS) and bone block procedures have emerged as promising solutions for complex instability cases. In rotator cuff repair, innovations such as the suture-bridge double-row technique, superior capsular reconstruction (SCR), and biological augmentation strategies, including dermal allografts and bioinductive patches, have contributed to improving tendon healing and functional outcomes. The role of biologic augmentation, including biceps tendon autografts and subacromial bursa augmentation, is also gaining traction in enhancing repair durability. : As arthroscopic techniques continue to evolve, the integration of biologic solutions and patient-specific surgical planning will likely define the future of shoulder surgery. This review provides a comprehensive assessment of current state-of-the-art techniques and discusses their clinical implications, with a focus on optimizing patient outcomes and minimizing surgical failure rates.
在过去几十年中，肩关节镜手术取得了显著进展，已从主要作为一种诊断工具转变为一种全面的治疗方法。技术创新和精细的手术技术扩大了关节镜检查的适应症，使得能够对肩关节不稳定和肩袖病变进行微创治疗。：本叙述性综述探讨了肩关节镜手术的历史演变、当前趋势和未来展望。：肩关节不稳定治疗的关键进展包括关节镜下Bankart修复术的演变、针对Hill-Sachs损伤的 remplissage技术的引入以及关节镜下Latarjet手术的发展。此外，动态前路稳定术（DAS）和骨块手术等新技术已成为复杂不稳定病例的有前景的解决方案。在肩袖修复方面，诸如缝线桥双排技术、上盂唇重建（SCR）以及包括真皮同种异体移植物和生物诱导贴片在内的生物增强策略等创新，有助于改善肌腱愈合和功能结果。生物增强的作用，包括肱二头肌肌腱自体移植和肩峰下囊增强，在提高修复耐久性方面也越来越受到关注。：随着关节镜技术不断发展，生物解决方案与针对患者的手术规划的整合可能将决定肩关节手术的未来。本综述对当前的先进技术进行了全面评估，并讨论了它们的临床意义，重点是优化患者预后并降低手术失败率。
