Joannette-Bourguignon Maude, Wong Ivan
Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Video J Sports Med. 2023 Feb 2;3(1):26350254221141906. doi: 10.1177/26350254221141906. eCollection 2023 Jan-Feb.
Anterior shoulder instability with glenoid bone loss is a complex condition. Bankart repairs have higher failure rate in this population and the Latarjet procedure is associated with a high complication rate (15%-30%). A recent technique, the arthroscopic anatomic glenoid reconstruction, safely uses distal tibial allograft to augment the glenoid.
Glenoid or bipolar bone loss in the setting of shoulder instability.
A diagnostic shoulder arthroscopy is performed to assess bone loss and capsulolabral tissue. After the preparation of the anterior glenoid, a bone block harvested from a distal tibial allograft is prepared. This technique uses the Halifax portal, a safe, far medial portal to insert the graft, and compress it onto the anterior glenoid using screws. A Bankart repair is then performed, to reduce the capsulolabral complex onto the glenoid.
Results at 2 years show a 92% to 100% union of the graft, no recurrence of instability, and improved patient-reported outcome scores. Graft remodeling is regularly observed on postoperative imaging. This procedure may be faster to learn and to perform compared to an arthroscopic Latarjet.
DISCUSSION/CONCLUSION: Arthroscopic anatomic glenoid reconstruction is a safe, minimally invasive procedure to address shoulder instability. It has low complication rate and is associated with improved patient-reported outcomes.
The author(s) attest that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
伴有肩胛盂骨缺损的前肩不稳是一种复杂病症。在这类人群中，Bankart修复术的失败率较高，而Latarjet手术的并发症发生率也很高（15%-30%）。一种最新技术，即关节镜下解剖性肩胛盂重建术，安全地使用胫骨远端异体骨来增大肩胛盂。
肩胛盂或双极骨缺损合并肩不稳。
进行诊断性肩关节镜检查以评估骨缺损情况和关节囊盂唇组织。在前肩胛盂准备好后，准备取自胫骨远端异体骨的骨块。该技术使用哈利法克斯入路，这是一个安全的、位于极内侧的入路来插入移植物，并用螺钉将其固定在前肩胛盂上。然后进行Bankart修复，将关节囊盂唇复合体复位至肩胛盂上。
2年时的结果显示移植物愈合率为92%至100%，无不稳复发，患者报告的结局评分有所改善。术后影像学检查经常观察到移植物重塑。与关节镜下Latarjet手术相比，该手术可能更容易学习和实施。
讨论/结论：关节镜下解剖性肩胛盂重建术是一种治疗肩不稳的安全、微创的手术。它并发症发生率低，且与患者报告的结局改善相关。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可能被识别，作者已随本投稿附上患者的豁免声明或其他书面批准形式以供发表。
