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关节镜下解剖学肩胛盂重建联合Bankart修复及关节囊填充术治疗伴双极骨丢失的复发性前肩关节不稳

Arthroscopic Anatomic Glenoid Reconstruction With Bankart Repair and Remplissage for Recurrent Anterior Shoulder Instability with Bipolar Bone Loss.

作者信息

Mbogori Makena, Coady Cathy, Wong Ivan

机构信息

Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.

Department of Orthopaedic Surgery, Nova Scotia Health, Halifax, Nova Scotia, Canada.

出版信息

Arthrosc Tech. 2024 Nov 16;14(4):103334. doi: 10.1016/j.eats.2024.103334. eCollection 2025 Apr.

DOI:10.1016/j.eats.2024.103334
PMID:40452994
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12126000/
Abstract

After first-time dislocation, the recurrence of instability requires less force as the result of associated injury of soft-tissue and bony stabilizing structures. Bone loss of either/both the glenoid and humeral head increases the risk of redislocation even after initial isolated soft-tissue stabilization. Several arthroscopic procedures have been described to address each of these pathologies individually. When combined, they address all pathologies in a single surgery and restore stability, reducing the need for a secondary procedure. This Technical Note describes an all-arthroscopic anatomic glenoid reconstruction with Bankart repair plus remplissage.

摘要

首次脱位后，由于软组织和骨性稳定结构的相关损伤，不稳定的复发所需力量较小。肩胛盂和肱骨头任何一方或双方的骨质流失都会增加再脱位的风险，即使最初进行了单纯的软组织稳定手术。已经描述了几种关节镜手术来分别处理这些病理情况。当联合使用时，它们可以在一次手术中处理所有病理情况并恢复稳定性，减少二次手术的必要性。本技术说明描述了一种全关节镜下的解剖学肩胛盂重建术，联合Bankart修复术和关节囊填充术。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1610/12126000/4652b66f8c26/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1610/12126000/b9e77d4fa29f/gr10.jpg
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相似文献

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Arthroscopic Anatomic Glenoid Reconstruction With Bankart Repair and Remplissage for Recurrent Anterior Shoulder Instability with Bipolar Bone Loss.关节镜下解剖学肩胛盂重建联合Bankart修复及关节囊填充术治疗伴双极骨丢失的复发性前肩关节不稳
Arthrosc Tech. 2024 Nov 16;14(4):103334. doi: 10.1016/j.eats.2024.103334. eCollection 2025 Apr.
2
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本文引用的文献

1
Bone loss in shoulder instability: putting it all together.肩关节不稳中的骨质流失：综合分析
Ann Jt. 2023 Jul 5;8:27. doi: 10.21037/aoj-23-6. eCollection 2023.
2
Remplissage in Addition to Arthroscopic Bankart Repair for Shoulder Instability With On-Track Hill-Sachs Lesions Reduces Residual Apprehension Without External Rotation Limitation.对于伴有“轨道型”Hill-Sachs 损伤的肩关节不稳定患者，在关节镜下 Bankart 修复术的基础上进行填充治疗可减少残余恐惧感，而不限制外旋。
Arthroscopy. 2023 Mar;39(3):692-702. doi: 10.1016/j.arthro.2022.10.013. Epub 2022 Oct 28.
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.
4
Arthroscopic Autologous Iliac Crest Grafting Results in Similar Outcomes and Low Recurrence Compared to Remplissage Plus Bankart Repair for Anterior Shoulder Instability With Bipolar Bone Defects.关节镜下自体髂嵴移植与 Remplissage 联合 Bankart 修复治疗伴双极骨缺损的复发性肩关节前不稳定疗效相似。
Arthroscopy. 2023 Jul;39(7):1600-1607. doi: 10.1016/j.arthro.2022.12.039. Epub 2023 Jan 25.
5
Consideration May Be Given to Lowering the Threshold for the Addition of Remplissage in Patients With Subcritical Glenoid Bone Loss Undergoing Arthroscopic Bankart Repair.对于接受关节镜下Bankart修复的临界以下肩胛盂骨缺损患者，可考虑降低增加 remplissage手术的阈值。
Arthrosc Sports Med Rehabil. 2022 Jun 4;4(4):e1283-e1289. doi: 10.1016/j.asmr.2022.04.004. eCollection 2022 Aug.
6
Calculating glenoid bone loss based on glenoid height using ipsilateral three-dimensional computed tomography.使用同侧三维计算机断层扫描基于关节盂高度计算关节盂骨丢失。
Knee Surg Sports Traumatol Arthrosc. 2023 Jan;31(1):169-176. doi: 10.1007/s00167-022-07020-4. Epub 2022 Jun 8.
7
Arthroscopic anatomic glenoid reconstruction has a lower rate of recurrent instability compared to arthroscopic Bankart repair while otherwise maintaining a similar complication and safety profile.与关节镜下Bankart修复术相比，关节镜下解剖学盂唇重建术复发性不稳定的发生率较低，同时在其他方面保持相似的并发症和安全性。
J ISAKOS. 2022 Oct;7(5):113-117. doi: 10.1016/j.jisako.2022.05.003. Epub 2022 May 29.
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Fixation Type Does not Affect the Learning Curve and Short-Term Radiographic Outcomes for Arthroscopic Anatomic Glenoid Reconstruction with Distal Tibia Allograft.固定类型不影响采用异体胫骨远端移植进行关节镜下解剖学肩胛盂重建的学习曲线和短期影像学结果。
Arthrosc Sports Med Rehabil. 2021 Nov 29;4(2):e371-e379. doi: 10.1016/j.asmr.2021.10.014. eCollection 2022 Apr.
9
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.
10
Age, participation in competitive sports, bony lesions, ALPSA lesions, > 1 preoperative dislocations, surgical delay and ISIS score > 3 are risk factors for recurrence following arthroscopic Bankart repair: a systematic review and meta-analysis of 4584 shoulders.年龄、参与竞技体育、骨损伤、ALPSA 损伤、术前脱位次数>1、手术延迟和 ISIS 评分>3 是关节镜下 Bankart 修复术后复发的危险因素：4584 例肩关节的系统评价和荟萃分析。
Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):4004-4014. doi: 10.1007/s00167-021-06704-7. Epub 2021 Aug 22.