摘要
肩关节上盂唇前后部(superior labrum anterior posterior,SLAP)损伤后肩关节盂上唇愈合能力有限,是骨科医师面临的一大挑战。肩关节镜手术是治疗SLAP损伤的金标准,但不同术式的适应人群、术中锚钉的选择、锚定时有结或者无结、固定技术等方面均存在争议。笔者认为:对于盂唇组织较完整的年轻(<35岁)或活动量较大的患者,肩关节镜下SLAP修复术效果显著,且术中应尽量使用单锚固定,固定时采用无结缝合锚定方式;对于盂唇组织存在退变、磨损的年龄较大(≥35岁)的患者,肩关节镜下肱二头肌肌腱固定术更具优势,手术中优选干扰螺钉固定技术进行固定;对于Ⅰ期SLAP修复术失败的患者,Ⅱ期补救治疗采用肱二头肌肌腱固定术可以取得良好的效果。本文通过查阅近年该领域相关文献,对关节镜治疗SLAP损伤的不同术式的适应人群、术中锚钉技术、固定方式及近年来一些改良术式等进行综述,以指导临床治疗。
Superior labrum anterior posterior(SLAP)injury is a major challenge for orthopedic surgeons,due to the poor healing ability of the injured labrum.Although arthroscopic surgery is the gold standard for the treatment of SLAP injury,there are still disputes about the adaptation of different surgical techniques,the choice of anchors during operation,knotted or knotless anchors,and fixation methods.The authors believe that arthroscopic repair of SLAP lesions is effective for young patients with intact glenoid labrum(<35 years old)or with extensive activity,where single and knotless anchor is preferred.For the older patients(≥35 years old)with degeneration and wear of glenoid labrum,biceps tenodesis is more preferable,and interference screw fixation technique is recommended.As for patients with failed SLAP repair,biceps tenodesis can achieve a high success rate as a revision surgery.By review of the relevant literature in recent years,this paper summarizes the adaptation of different surgical methods of arthroscopic treatment of SLAP injury,intraoperative anchoring techniques,fixation methods and other improved surgical techniques.
作者
杨智涛
张明涛
周建平
吴定
刘涛
张柏荣
韵向东
YANG Zhi-tao;ZHANG Ming-tao;ZHOU Jian-ping;WU Ding;LIU Tao;ZHANG Bo-rong;YUN Xiang-dong(Department of Orthopaedics,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China;Key Laboratory of Bone and Joint Disease of Gansu Province,Lanzhou730030,Gansu,China)
出处
《中国骨伤》
CAS
CSCD
2023年第2期193-198,共6页
China Journal of Orthopaedics and Traumatology
基金
兰州大学第二医院“萃英科技创新”计划(编号:CY2019-BJ04)。
