Morgan C D, Burkhart S S, Palmeri M, Gillespie M
Department of Orthopaedic Surgery, Alfred I. DuPont Institute, Wilmington, Delaware, USA.
Arthroscopy. 1998 Sep;14(6):553-65. doi: 10.1016/s0749-8063(98)70049-0.
One hundred two type II SLAP lesions without associated anterior instability, Bankart lesion, or anterior inferior labral pathology were surgically treated under arthroscopic control. There were three distinct type II SLAP lesions based on anatomic location: anterior (37%), posterior (31%), and combined anterior and posterior (31%). Preoperatively, the Speed and O'Brien tests were useful in predicting anterior lesions, whereas the Jobe relocation test was useful in predicting posterior lesions. Rotator cuff tears were present in 31% of patients and were found to be lesion-location specific. In posterior and combined anterior-posterior lesions, a drive-through sign was always present (despite absence of anterior-inferior labral pathology or a Bankart lesion) and was eliminated by repair of the posterior component of the SLAP lesion. We conclude that SLAP lesions with a posterior component develop posterior-superior instability that manifests itself by a secondary anterior-inferior pseudolaxity (drive-through sign), and that chronic superior instability leads to secondary lesion-location-specific rotator cuff tears that begin as partial thickness tears from inside the joint.
102例无相关前向不稳定、Bankart损伤或前下盂唇病变的II型SLAP损伤在关节镜控制下接受手术治疗。根据解剖位置有三种不同的II型SLAP损伤：前部（37%）、后部（31%）以及前后部联合（31%）。术前，Speed试验和奥布赖恩试验有助于预测前部损伤，而乔布重新定位试验有助于预测后部损伤。31%的患者存在肩袖撕裂，且发现其具有损伤部位特异性。在后部及前后部联合损伤中，始终存在贯通征（尽管无前下盂唇病变或Bankart损伤），且通过修复SLAP损伤的后部成分可消除该征象。我们得出结论，伴有后部成分的SLAP损伤会导致后上不稳定，其表现为继发性前下假性松弛（贯通征），并且慢性上不稳定会导致继发性损伤部位特异性肩袖撕裂，这种撕裂始于关节内的部分厚度撕裂。
