remplissage -姜春岩教授 2_肩关节培训班.pdf

Arthroscopic Remplissage 姜春岩 Chunyan Jiang MD Ph.D Professor, Shoulder Service Beijing Ji Shui Tan Hospital School of Medicine, Peking University Glenoid bone defect in anterior instability • High failure rate if treated only by soft tissue recon • 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 • “Kissing lesion”: Bony defect + huge Hill-Sach’s the Inverted-Pear Glenoid and the Humeral Engaging Hill-Sachs Lesion. Arthroscopy, Vol 16, No 7 (October), 2000: pp 677–694 Bony Bankart – Bony defect Arthroscopic approach • Glenoid defect 20%: Arthroscopic Latarjet • 15% defect 20% + big Hill-Sachs: Bankart repair + Infra tenodesis: “Remplissage” History of Remplissage Open transfer of the infraspinatus tendon for large Hill-Sachs lesion Connolly JF.. Instr Course Lect 1972 Remplissage - mechanism Remplissage • Current reports about Remplissage – 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 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 O