Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Arthroscopic Reconstruction of Bony Defect in Shoulder Instability

골 결손을 동반한 견관절 불안정성의 관절경적 재건술

  • Kim, Yang-Soo (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Ok, Ji-Hoon (Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 김양수 (가톨릭대학교 의과대학 정형외과학교실) ;
  • 옥지훈 (가톨릭대학교 의과대학 정형외과학교실)
  • Received : 2011.05.10
  • Accepted : 2011.06.27
  • Published : 2011.06.30
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Abstract

Purpose: We reviewed arthroscopic reconstruction among the several treatment options for anterior shoulder instability with a bony Bankart lesion. Materials and Methods: Although open Bankart repair has long been considered the optimal surgical management of anterior shoulder instability, advancements in arthroscopic techniques have led to a recent shift to arthroscopic Bankart repair. However, for cases of a glenoid bony defect, several authors have reported various methods to accurately measure the amount of bony defect. Results: The arthroscopic technique of bony Bankart reconstruction continues to evolve and various methods have followed. To overcome the limitations of single fixation of a Bankart lesion, arthroscopic dual fixation (2 point fixation) has recently been tried to anatomically repair and restore the rigid fixation of a bony fragment. The concept of performing the Bristow-Latarjet transfer procedure under arthroscopy has also recently emerged. However, a large series of cases and long term follow up are required to prove the better results. Conclusion: To obtain a successful outcome for patients with anterior instability with a glenoid bony defect, it is imperative that the surgeon be aware of the accurate status of the bony defect and the intraoperative, postoperative factors associated with the proper treatment of this unstable pathology.

목적: 골성 방카르트 병변의 여러 가지 치료 방법 중 관절경적 재건술에 대하여 문헌 고찰과 함께 대략적으로 설명하기로 한다. 대상 및 방법: 견관절 전방 불안정성의 치료에 있어 관절경적 복원술의 임상결과 향상으로 개방적 수술보다 관절경적 수술을 더욱 선호하게 되었고 점차 표준 치료법으로 인정받게 되었다. 그러나 관절와의 골 결손이 있는 경우 골 결손의 정도를 측정하는 방법은 연구자에 따라 다양하며 관절경적 복원술의 방법 또한 지속적 발전과 함께 다양하게 소개되고 있다. 결과: 골 결손의 관절경적 재건술 중 방카르트 병변의 이열 봉합술은 일열 봉합술의 단점을 보완하여 보다 견고한 고정과 해부학적 복원을 위해 최근에 소개되었으나 앞으로 많은 증례와 장기간 추시를 통해 그 결과가 입증되어야 할 것이다. 또한 관절경을 이용한 오구돌기 이전술, 즉 Bristow-Latarjet 술식 등 여러 가지 방법이 시도되고 있다. 결론: 전방 불안정성 환자의 관절경적 치료 방법은 다양하게 시도되고 있으며 지속적인 발전을 거듭하고 있다. 성공적인 결과를 얻기 위해서는 수술 전 환자의 골 결손 상태를 정확히 파악해야 하며 치료와 연관된 술 중, 술 후 요소들을 잘 알고 있어야 한다.

Keywords

References

  1. Bottoni CR, Smith EL, Berkowitz MJ, Towle RB, Moore JH. Arthroscopic versus open shoulder stabilization for recurrent anterior instability: A prospective randomized clinical trial. Am J Sports Med. 2006;34:1730-7. https://doi.org/10.1177/0363546506288239
  2. Freedman KB, Smith AP, Romeo AA, Cole BJ, Bach BR Jr. Open bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder: A meta-analysis. Am J Sports Med. 2004;32:1520-7. https://doi.org/10.1177/0363546504265188
  3. Kim SH, Ha KI, Park JH, et al. Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder. J Bone Joint Surg Am. 2003;85:1479-87.
  4. Curtis AS, Burbank KM, Tierney JJ, Scheller AD, Curran AR. The insertional footprint of the rotator cuff: An anatomic study. Arthroscopy. 2006;22:603-9. https://doi.org/10.1016/j.arthro.2006.04.001
  5. Lo IKY, Burkhart SS. Double-row arthroscopic rotator cuff repair: Re-establishing the footprint of the rotator cuff. Arthroscopy. 2003;19:1035-42. https://doi.org/10.1016/j.arthro.2003.09.036
  6. Kim DH, Eiattrache NS, Tibone JE, et al. Biomechanical comparison of a single-row versus doublerow suture anchor technique for rotator cuff repair. Am J Sports Med. 2006;34:407-14.
  7. Meier SW, Meier JD. The effect of double-row fixation on initial repair strength in rotator cuff repair: A biomechanical study. Arthroscopy. 2006;22:1168-73. https://doi.org/10.1016/j.arthro.2006.07.004
  8. Porcellini G, Paladini P, Campi F, Paganelli M. Long-term outcome of acute versus chronic bony bankart lesions managed arthroscopically. Am J Sports Med. 2007;35:2067-72. https://doi.org/10.1177/0363546507305011
  9. Arciero RA, Wheeler JH, Ryan JB , McBride JT. Arthroscopic bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med. 1994;22:589-94. https://doi.org/10.1177/036354659402200504
  10. De Palma AF. Fracture and fracture-dislocation of the shoulder girdle. Surgery of the shoulder. 3 ed, Lippincott: Philadelphia; 1983. 366-7.
  11. Gazielly D, Godeneche J. The use of coracoid transfer for recurrent anterior glenohumeral instability. Surgical Disorders of the Shoulder. London, UK: Churchill Livingstone; 1991. 355-62.
  12. Ideberg R. Fractures of the scapula involving the glenoid fossa. Surgery of the shoulder. Philadelphia: BC Decker; 1984. 63-6.
  13. Cameron S. Arthroscopic reduction and internal fixation of an anterior glenoid fracture. Arthroscopy. 1998;14:743-6. https://doi.org/10.1016/S0749-8063(98)70102-1
  14. Rowe C, Patel D, Southmayd W. The bankart procedure: A long-term end-result study. J Bone Joint Surg Am. 1978;60:1-16.
  15. Itoi E, Lee SB, Berglund LJ, Berge LL, An K. The effect of a glenoid defect on anteroinferior stability of the shoulder after bankart repair: A cadaveric study. J Bone Joint Surg Am. 2000;82:35-46.
  16. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic bankart repairs. Arthroscopy. 2000;16:677-94. https://doi.org/10.1053/jars.2000.17715
  17. Heggland EJH, Parker RD. Simultaneous bilateral glenoid fractures associated with glenohumeral subluxation/dislocation in a weightlifter. Discussion. Orthopedics. 1997;20:1180-4.
  18. Porcellini G, Campi F, Paladini P. Arthroscopic approach to acute bony bankart lesion. Arthroscopy. 2002;18:764-9. https://doi.org/10.1053/jars.2002.35266
  19. Bigliani LU, Newton PM, Steinmann SP, Connor PM, Mcilveen SJ. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med. 1998;26:41-5.
  20. Sugaya H, Moriishi J, Kanisawa I, Tsuchiya A. Arthroscopic osseous bankart repair for chronic recurrent traumatic anterior glenohumeral instability. J Bone Joint Surg Am. 2005;87:1752-60. https://doi.org/10.2106/JBJS.D.02204
  21. Millett PJ, Braun S. The "bony bankart bridge" procedure: A new arthroscopic technique for reduction and internal fixation of a bony bankart lesion. Arthroscopy. 2009;25:102-5. https://doi.org/10.1016/j.arthro.2008.07.005
  22. Yoneda M. New concept of arthroscopic bankart repair: Double anchor footprint fixation (daff) technique. J Joint Surgery. 2005;24:1305-16.
  23. Lafosse L, Baier GP, Jost B. Footprint fixation for arthroscopic reconstruction in anterior shoulder instability: The cassiopeia double-row technique. Arthroscopy. 2006;22:231-6.
  24. Kim KC, Rhee KJ, Shin HD. Arthroscopic threepoint double-row repair for acute bony bankart lesions. Knee Surg Sports Traumatol Arthrosc. 2009;17: 102-6. https://doi.org/10.1007/s00167-008-0659-y
  25. Wang DW, Getelman MH. "Hospital-corner repair" for shoulder instability. Arthroscopy. 2010;26:1706-9. https://doi.org/10.1016/j.arthro.2010.08.009
  26. Boileau P, Bicknell RT, El Fegoun AB, Chuinard C. Arthroscopic bristow procedure for anterior instability in shoulders with a stretched or deficient capsule. Arthroscopy. 2007;23:593-601. https://doi.org/10.1016/j.arthro.2007.03.096
  27. Lafosse L, Lejeune E, Bouchard A, Kakuda C, Gobezie R, Kochhar T. The arthroscopic latarjet procedure for the treatment of anterior shoulder instability. Arthroscopy. 2007;23:1241-5.
  28. Latarjet M. Treatment of recurrent dislocation of the shoulder. Lyon chirurgical. 1954;49:994-7.
  29. Boileau P, Mercier N, Old J. Arthroscopic bankartbristow- latarjet (2b3) procedure: How to do it and tricks to make it easier and safe. Orthopedic Clinics North America. 2010;41:381-92. https://doi.org/10.1016/j.ocl.2010.03.005

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