复发性肩关节前脱位伴骨缺损的治疗进展  

Progress on the treatment of recurrent anterior dislocation of shoulder with bone defect

作　　者：吴定 周建平 张广瑞 刘嘉鑫 张明涛 安丽萍[1,2] 敏思聪 贾耀飞 韵向东 WU Ding;ZHOU Jian-ping;ZHANG Guang-rui;LIU Jia-xin;ZHANG Ming-tao;AN Li-ping;MIN Si-cong;JIA Yao-fei;YUN Xiang-dong(*Department of Orthopaedics,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州大学第二医院骨科,甘肃兰州730030 [2]甘肃省骨关节疾病研究重点实验室,甘肃兰州730030 [3]长武县人民医院,陕西咸阳713600

出　　处：《中国骨伤》2021年第9期887-890,共4页China Journal of Orthopaedics and Traumatology

基　　金：兰大二院翠英科技创新计划临床拔尖技术项目(编号:CY2019-BJ04)。

摘　　要：复发性肩关节前脱位伴骨缺损是肩关节常见疾病之一。如何有效地修复关节盂骨缺损,降低肩关节脱位复发率是临床医师关注的问题。骨移植术能够发挥骨刺激作用,促进骨再生和骨重塑,恢复关节盂的正常解剖结构。其中,Bristow-Latarjet术是治疗复发性肩关节脱位的经典术式,Latarjet术能够修复更大的关节盂骨缺损,但对手术医师的操作要求更高;自体髂骨移植术是Latarjet术失败后翻修的首选方案;骨软骨移植术(自体和异体)在重建原始关节面和预防关节退行性改变方面有一定的优势,但自体骨软骨移植术会造成二次损伤,而异体骨软骨移植术的免疫排斥难以避免。随着复合材料的改进,对骨再生、重塑机制的探究,以及结合骨移植术的优缺点,组织工程技术将来有可能成为治疗关节盂骨缺损的重要方法。Recurrent anterior dislocation of shoulder with bone defect is one of the common diseases of shoulder joint.How to effectively repair glenoid bone defect and reduce recurrence rate of shoulder dislocation is a problem that clinicians focus on.Bone grafting could stimulate bone,promote bone regeneration and bone remodeling,and restore the normal anatomical structure of glenoid.Among them,Bristow-Latarjet procedure is a classic operation for recurrent shoulder dislocation.Latarjet procedure could repair larger glenoid bone defects,but with higher surgical skills for surgeons;autogenous iliac grafting is the first choice for revision once Latarjet procedure failed;osteochondral grafting(autogenous and allogenous)has certain advantages in reconstructing original articular surface and preventing joint degeneration,but autologous osteochondral grafting may cause secondary injury,while immune rejection is difficult to avoid for allogenous osteochondral grafting.With the improvement of composite materials,and the mechanism of bone regeneration and remodeling,as well as the advantages and disadvantages of bone grafting,tissue engineering technology may become an effective method for the treatment of glenoid bone defect in the future.

关 键 词：肩脱位 复发 综述 

分 类 号：R684.7[医药卫生—骨科学]