Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss  

作　　者：Eamon Ramhamadany Chetan S Modi 

机构地区：[1]Coventry and Warwic-kshire Shoulder and Elbow Unit, University Hospitals Coventry and Warwickshire NHS Trust

出　　处：《World Journal of Orthopedics》2016年第6期343-354,共12页世界骨科杂志（英文版）

摘　　要：The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of boneloss.It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency,humeral bone deficiency or combined bipolar lesions.It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery.The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects.The treatment of humeral defects is more controversial,however,although good early results have been reported after arthroscopic Remplissage for small defects.Larger humeral defects may require complex reconstruction or partial resurfacing.There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions.The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of boneloss.It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency,humeral bone deficiency or combined bipolar lesions.It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery.The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects.The treatment of humeral defects is more controversial,however,although good early results have been reported after arthroscopic Remplissage for small defects.Larger humeral defects may require complex reconstruction or partial resurfacing.There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions.The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.

关 键 词：SHOULDER dislocation Bone loss LATARJET HILL-SACHS LESION Remplissage 

分 类 号：R684[医药卫生—骨科学]