PDF(Pubmed)
Abstract：
The stability of the glenohumeral joint, known for its remarkable mobility, relies on several factors, including the congruency of the joint\'s bones and the integrity of capsulolabral structures, encompassing the labrum, the capsule, and the glenohumeral ligaments. In cases of anterior shoulder instability, bone lesions are a common occurrence, most frequently involving glenoid bone loss and Hill-Sachs lesions. When both glenoid and humeral bone lesions coexist, the isolated Bankart procedure has exhibited a significant rate of failure. In such instances, the Latarjet procedure, especially when bone loss is present, retains its position as the gold standard, thanks to its consistent success in both short- and long-term outcomes. Recent advancements in research have explored alternative strategies to address bone loss, including the Remplissage procedure for humeral bone deficits and the use of bone block grafts to manage glenoid bone lesions, with a focus on achieving more anatomical techniques. However, it\'s crucial to recognize that, beyond bone loss, a multitude of intrinsic and extrinsic factors come into play when determining the most suitable treatment. The patient\'s profile, including factors like constitutional laxity and activity level, must be carefully considered in the decision-making process. The Latarjet procedure maintains its esteemed status as a benchmark in the field, thanks to its consistent excellence in both short- and long-term results. This article seeks to provide insights into the roles and placement of various surgical techniques within the context of chronic anterior shoulder instability, taking into account the intricate interplay of factors that influence treatment decisions.
摘要：
肱骨关节的稳定性，以其非凡的机动性而闻名，依赖于几个因素，包括关节骨的一致性和囊膜结构的完整性，包围着唇，胶囊,和肱骨韧带.在肩前不稳定的情况下，骨病变是常见的，最常见的是关节盂骨丢失和Hill-Sachs病变。当关节盂和肱骨病变同时存在时，孤立的Bankart程序表现出明显的失败率。在这种情况下,Latarjet程序，尤其是当存在骨质流失时，保持其作为黄金标准的地位，由于其在短期和长期结果方面的持续成功。研究的最新进展探索了解决骨质流失的替代策略，包括治疗肱骨骨缺损的Remplissage手术和使用骨块移植来治疗关节盂骨病变，专注于实现更多的解剖学技术。然而,认识到这一点至关重要，除了骨质流失，在确定最合适的治疗方法时，许多内在和外在因素发挥作用。病人的资料,包括宪法松弛和活动水平等因素，在决策过程中必须仔细考虑。Latarjet程序保持其在该领域的基准地位，由于其在短期和长期结果方面的一贯卓越。本文旨在提供有关慢性肩关节前不稳定背景下各种手术技术的作用和放置的见解，考虑到影响治疗决策的因素的复杂相互作用。
