Prevention and management of post-instability glenohumeral arthropathy  

作　　者：Brian R Waterman Kelly G Kilcoyne Stephen A Parada Josef K Eichinger 

机构地区：[1]Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center [2]Eisenhower Army Medical Center [3]Madigan Army Medical Center

出　　处：《World Journal of Orthopedics》2017年第3期229-241,共13页世界骨科杂志（英文版）

摘　　要：Post-instability arthropathy may commonly develop in high-risk patients with a history of recurrent glenohumeral instability,both with and without surgical stabilization.Classically related to anterior shoulder instability,the incidence and rates of arthritic progression may vary widely.Radiographic arthritic changes may be present in up to two-thirds of patients after primary Bankart repair and 30%after Latarjet procedure,with increasing rates associated with recurrent dislocation history,prominent implant position,non-anatomic reconstruction,and/or lateralized bone graft placement.However,the presence radiographic arthrosis does not predict poor patient-reported function.After exhausting conservative measures,both joint-preserving and arthroplasty surgical options may be considered depending on a combination of patient-specific and anatomic factors.Arthroscopic procedures are optimally indicated for individuals with focal disease and may yield superior symptomatic relief when combined with treatment of combined shoulder pathology.For more advanced secondary arthropathy,total shoulder arthroplasty remains the most reliable option,although the clinical outcomes,wear characteristics,and implant survivorship remains a concern among active,young patients.Post-instability arthropathy may commonly develop in high-risk patients with a history of recurrent glenohumeral instability,both with and without surgical stabilization.Classically related to anterior shoulder instability,the incidence and rates of arthritic progression may vary widely.Radiographic arthritic changes may be present in up to two-thirds of patients after primary Bankart repair and 30%after Latarjet procedure,with increasing rates associated with recurrent dislocation history,prominent implant position,non-anatomic reconstruction,and/or lateralized bone graft placement.However,the presence radiographic arthrosis does not predict poor patient-reported function.After exhausting conservative measures,both joint-preserving and arthroplasty surgical options may be considered depending on a combination of patient-specific and anatomic factors.Arthroscopic procedures are optimally indicated for individuals with focal disease and may yield superior symptomatic relief when combined with treatment of combined shoulder pathology.For more advanced secondary arthropathy,total shoulder arthroplasty remains the most reliable option,although the clinical outcomes,wear characteristics,and implant survivorship remains a concern among active,young patients.

关 键 词：ARTHROPATHY GLENOHUMERAL DISLOCATION LATARJET INSTABILITY 

分 类 号：R687.4[医药卫生—骨科学]