王星宇;谢水华;丁浩;张文庆;王小鹏;刘霞;

• 1:江西中医药大学研究生院
• 2:江西中医药大学附属中西医结合医院骨一科
• 3:江西省妇幼保健院肿瘤科

摘要(Abstract)：

骨性Bankart损伤是与肩关节前方不稳定相伴随存在的肩盂前缘的骨折或骨缺损,其发生率在肩关节前脱位中占4%~70%,临床及生物力学研究显示,当骨缺损的面积>20%~25%时,单纯行软组织的修复如Bankart修复术效果不佳,建议行骨质重建,如Latarjet术、取自体髂骨或异体骨植骨术等。目前行切开手术修复治疗已十分娴熟,但开放手术存在创伤大、出血多、对关节活动度影响大等缺点。随着关节镜工具及技术的发展,目前可以在全关节镜下处理骨性Bankart损伤。本文就骨性Bankart损伤的分类、生物力学背景、临床评估及关节镜下处理骨性Bankart损伤的手术方法及临床疗效作一综述,为临床骨科医师在行肩关节镜治疗此病时提供借鉴与参考。

关键词(KeyWords)： 关节镜,;骨性Bankart损伤,;肩关节不稳定,;综述

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王星宇;谢水华;丁浩;张文庆;王小鹏;刘霞;

Email:

DOI:

参考文献(References)：

• [1]Porcellini G,Campi F,Paladini P.Arthroscopic approach to acute bony Bankart lesion[J].Arthroscopy,2002,18(7):764-769.
• [2]Bigliani LU,Newton PM,Steinmann SP,et al.Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder[J].Am J Sports Med,1998,26(1):41-45.
• [3]Kim YK,Cho SH,Son WS,et al.Arthroscopic repair of small and Medium-Sized bony bankart lesions[J].Am J Sports Med,2014,42(1):86-94.
• [4]Itoi E,Lee SB,Berglund LJ,et al.The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair:a cadaveric study[J].J Bone Joint Surg Am,2000,82(1):35-46.
• [5]Yamamoto N,Itoi E,Abe H,et al.Effect of an anterior glenoid defect on anterior shoulder stability:a cadaveric study[J].Am J Sports Med,2009,37(5):949-954.
• [6]Balg F,Boileau P.The instability severity index score.A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation[J].J Bone Joint Surg Br,2007,89(11):1470-7.
• [7]Audrey DR,Frédéric B,Martin BJ,et al.Indication for computed tomography scan in shoulder instability:sensitivity and specificity of standard radiographs to predict bone defects after traumatic anterior glenohumeral instability[J].Orthop J Sports Med,2017,5(10):2325967117733660.
• [8]Jaros?aw S,Zofia PM,Wojciech W,et al.The Bony Bankart Lesion:How to Measure the Glenoid Bone Loss[J].Pol J Radiol,2017,82(1):58-63.
• [9]Gottschalk Lionel J,Bois Aaron J,Shelby Marcus A,et al.Mean glenoid defect size and location associated with anterior shoulder instability:a systematic review[J].Orthop J Sports Med,2017,5(1):2325967116676269.
• [10]Yang Justin S,Mazzocca Augustus D,Cote Mark P,et al.Recurrent anterior shoulder instability with combined bone loss:treatment and results with the modified Latarjet procedure[J].Am J Sports Med,2016,44(4):922-32.
• [11]Millett PJ,Braun S.The“bony Bankart bridge”procedure:a new arthroscopic technique for reduction and internal fixation of a bony Bankart lesion[J].Arthroscopy,2009,25(1):102–105.
• [12]Mohamed A,Johannes PE,Gernot S,et al.Results of arthroscopic Bankart repair for anterior-inferior shoulder instability at 13-year follow-up[J].Am J Sports Med,2017,45(4):782-787.
• [13]潘昭勋,钟彬,孙超,等.创伤性复发性肩关节前脱位全关节镜下与切开术式治疗的临床疗效对比[J].中国矫形外科杂志,2016,24(06):515-520.
• [14]David PA,Michael B,Sarah HJ,et al.Arthroscopic treatment of osseous instability of the shoulder[J].HSS J,2017,13(3):292-301.
• [15]Owens Brett D,Harrast John J,Hurwitz Shepard R,et al.Surgical trends in Bankart repair:an analysis of data from the American Board of Orthopaedic Surgery certification examination[J].Am J Sports Med,2011,39(9):1865-1869.
• [16]刘运晃,王明新,姜华,等.肩关节镜下应用免打结技术Pushlock固定治疗肩关节复发性不稳[J].中国矫形外科杂志,2016,24(20):1831-1833.
• [17]Yoshiyasu U,Akiyoshi H,Eiji S,et al.Open Bankart repair plus inferior capsular shift versus arthroscopic Bankart repair without augmentations for traumatic anterior shoulder instability:a prospective study[J].J Orthop Surg(Hong Kong),2017,25(3):2309499017727947.
• [18]Zhu Yi-Ming,Jiang Chunyan,Song Guanyang,et al.Arthroscopic Latarjet procedure with anterior capsular reconstruction:clinical outcome and radiologic evaluation with a minimum 2-year followup[J].Arthroscopy,2017,33(12):2128-2135.
• [19]Lafosse L,Lejeune E,Bouchard A,et al.The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability[J].Arthroscopy,2007,23(11):1242.e1–1242.e5.
• [20]Lafosse L,Boyle S,Gutierrez-Aramberri M,et al.Arthroscopic Latarjet procedure[J].Orthop Clin North Am,2010,41(3):393–405.
• [21]Adriano R,Andrea G,Annalisa A,et al.Accuracy of coracoid bone graft placement:open versus arthroscopic Latarjet[J].Joints,2017,5(2):85-88.
• [22]Bart?omiej K,Konrad M,Maciej K,et al.Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability(Latarjet)-clinical results at short term follow-up[J].Int Orthop,2017,41(5):1023-1033.
• [23]Cowling P D,Akhtar M A,Liow R Y L.What is a Bristow-Latarjet procedure?A review of the described operative techniques and outcomes[J].Bone Joint J,2016,98-B(9):1208-14.
• [24]常崇斐,崔家鸣,熊建义,等.伴关节盂骨质缺损的复发性肩关节前脱位的全关节镜下Bristow-Latarjet术治疗进展[J].中国运动医学杂志,2017,36(1):65-69.
• [25]Boileau P,Mercier N,Old J.Arthroscopic Bankart–Bristow–Latarjet(2B3)procedure:How to do it and tricks to make it easier and safe[J].Orthop Clin North Am,2010,41(3):381–392.
• [26]Boileau P,Thélu Cé,Mercier N,et al.Arthroscopic Bristow–Latarjet combined with Bankart repair restores shoulder stability in patients with glenoid bone loss[J].Clin Orthop,2014,472(8):2413–2424.
• [27]Chad FM,Ivan W,Joseph BP.Arthroscopic iliac crest bone grafting to the anterior glenoid[J].Arthrosc Tech,2016,5(4):e907-e912.
• [28]Taverna E,GolanòP,Pascale V,et al.An arthroscopic bone graft procedure for treating anterior-inferior glenohumeral instability[J].Knee Surg Sports Traumatol Arthrosc,2008,16(9):872–875.
• [29]Scheibel Markus,Kraus Natascha,Diederichs Gerd,et al.Arthroscopic reconstruction of chronic anteroinferior glenoid defect using an autologous tricortical iliac crest bone grafting technique[J].Arch Orthop Trauma Surg,2008,128(11):1295-300.
• [30]Taverna E,D’Ambrosi R,Perfetti C,et al.Arthroscopic bone graft procedure for anterior inferior glenohumeral instability[J].Arthrosc Tech,2014,3(6):e653–e660.
• [31]Kraus Natascha,Amphansap Tanawat,Gerhardt Christian,et al.Arthroscopic anatomic glenoid reconstruction using an autologous iliac crest bone grafting technique[J].J Shoulder Elbow Surg,2014,23(11):1700-8.
• [32]Anderl Werner,Pauzenberger Leo,Laky Brenda,et al.Arthroscopic implant-free bone grafting for shoulder instability with glenoid bone loss:clinical and radiological outcome at a minimum 2-year follow-up[J].Am J Sports Med,2016,44(5):1137-45.