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关节镜下无结双束肩胛下盂肱韧带重建治疗静态性肩关节下脱位

Arthroscopic Knotless Double-Bundle Inferior Glenohumeral Ligament Reconstruction for Static Inferior Shoulder Subluxation.

作者信息

Hachem Abdul-Ilah, Barraza Gonzalo, Alvarado Fernando, Rius Xavier, Arenas-Miquelez Antonio

机构信息

Department of Orthopedic Surgery, Bellvitge University Hospital (L'Hospitalet de Llobregat), Barcelona, Spain.

University of Barcelona, Barcelona, Spain.

出版信息

Arthrosc Tech. 2025 Jan 11;14(5):103421. doi: 10.1016/j.eats.2024.103421. eCollection 2025 May.

Abstract

Inferior subluxation of the humeral head may lead to ongoing shoulder instability after attempted stabilization procedures. This implies a challenging situation for the surgeon to address, and the cause is unclear. However, ligament insufficiency of the rotator interval complex and abnormal muscle activation of the rotator cuff and deltoid are common contributing factors. Currently, there is no fair solution for these patients, and they end up being treated with either glenohumeral arthrodesis or reverse shoulder arthroplasty. However, reconstruction of the inferior glenohumeral ligament may reinforce the hammock formed by the native inferior glenohumeral ligament and could potentially prevent inferior subluxation and preserve the shoulder joint. We describe an all-arthroscopic knotless double-bundle anatomic reconstruction of the inferior glenohumeral ligament using a semitendinosus allograft for patients with inferior subluxation of the humeral head who have already undergone unsuccessful stabilization surgeries.

摘要

肱骨头下脱位在尝试稳定手术之后可能导致持续的肩关节不稳。这给外科医生带来了一个具有挑战性的情况,且病因尚不清楚。然而,旋转间隙复合体的韧带不足以及肩袖和三角肌的异常肌肉激活是常见的促成因素。目前,对于这些患者没有合适的解决方案,他们最终接受的治疗要么是盂肱关节固定术,要么是反式肩关节置换术。然而,重建下盂肱韧带可能会加强由天然下盂肱韧带形成的吊床结构,并有可能防止下脱位以及保留肩关节。我们描述了一种全关节镜下使用半腱肌同种异体移植物对已经接受过失败稳定手术的肱骨头下脱位患者进行无结双束解剖重建下盂肱韧带的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bff8/12177461/9e9d7b4f5a00/gr1.jpg

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