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关节镜下喙突切除、联合肌腱及胸小肌松解治疗反式肩关节置换术后肩前疼痛和撞击症

Arthroscopic Coracoid Excision, Conjoint Tendon, and Pectoralis Minor Release for Anterior Shoulder Pain and Impingement After Reverse Shoulder Arthroplasty.

作者信息

Satalich James, Wiley Nicholas, Elhassan Bassem, Lohre Ryan

机构信息

Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, MGH Scapula Program, Boston, Massachusetts, U.S.A.

出版信息

Arthrosc Tech. 2025 Jul 11;14(8):103712. doi: 10.1016/j.eats.2025.103712. eCollection 2025 Aug.

Abstract

Anterior shoulder pain after reverse shoulder arthroplasty (RSA) is both challenging to diagnose and treat and can be attributed to the conjoint tendon, coracoid process, and pectoralis minor. Various open and arthroscopic techniques have been proposed to address singular aspects of these painful structures, although a global treatment has not been described. Herein we describe an all-arthroscopic approach to the treatment of anterior shoulder pain after RSA, incorporating subacromial and subdeltoid decompression, conjoint tendon release, pectoralis minor release, and coracoid excision. This addresses both bony and soft-tissue aspects of subcoracoid impingement and altered muscular tension after RSA.

摘要

反式肩关节置换术(RSA)后出现的肩关节前方疼痛在诊断和治疗方面都具有挑战性,可能归因于联合腱、喙突和胸小肌。尽管尚未有针对这些疼痛结构的全面治疗方法的描述,但已提出了各种开放和关节镜技术来处理这些疼痛结构的个别方面。在此,我们描述一种全关节镜方法来治疗RSA后的肩关节前方疼痛,包括肩峰下和三角肌下减压、联合腱松解、胸小肌松解和喙突切除。这解决了RSA后喙突下撞击的骨和软组织方面以及肌肉张力改变的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6a0/12420606/7d2f824d9ade/gr1.jpg

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