remplissage -姜春岩教授 2_肩关节培训班.pptxVIP

Arthroscopic Remplissage • 4% recurrent rate (7/173) in patients without significant bone defects vs. 67% (14/21) in patients with significant bone defects • Contact athlete with significant bone defects: 89% recurrent rate Glenoid bone defect in anterior instability • Infra tenodesis: “Remplissage” • • Open transfer of the infraspinatus tendon for large Hill-Sachs lesion History of Remplissage Connolly JF.. Instr Course Lect 1972 - mechanism – Technical Note: • Wolf, E. M.: Arthroscopy,2007 • Purchase, R. J. : Arthroscopy,2008 • Koo,S.S.: Arthroscopy, 2009 • Toro,F: Technique in shoulder elbow surgery,2009 – Case report • Decreased Range of Motion Following Arthroscopic Remplissage Deutsch,A.A. : Orthopedics ,2008 • Current reports about Remplissage • Current reports about Remplissage – Case series • Zhu,YM. Jiang,CY. et.al.: AJSM, 2011 • Park,M.J.: Arthroscopy, 2011 • Nourissat,G.: AJSM, 2011 • Haviv,B.: J Orthop Surg Res, 2011 • Boileau, P.: JBJS-A. 2012 • Franceschi, F.: AJSM. 2012 • Rhee YG: 3rd CSES Congress, 2012 • Bankart repair + Infra tenodesis: “Remplissage” • Bankart repair + Infra tenodesis: “Remplissage” Glenoid defect 20% “Kissing lesion” - indication mean age: 28.4 years (16.7-54.7 ys) follow-up: 29.0 months (24-35 months). Arthroscopic Remplissage - clinical results 49 cases overall failure rate: 8.2% (4/49) healing of the infraspinatus tendon within the Hill- Sachs lesion: 100% ER lost: - 1.9° vs. preop, 8-10° vs. contalateral side Arthroscopic Bankart Repair Combined With Remplissage Technique for the Treatment of Anterior Shoulder Instability With Engaging Hill-Sachs Lesion A Report of 49 Cases With a Minimum 2-year Follow-up. AJSM 2011 Arthroscopic Remplissage - clinical results 47 cases, mean age: 29 Recurrence: 2% (1/47) Healing: all 42 with postop MRI E