Biomechanical Analysis Reveals Shoulder Instability With Bipolar Bone Loss Is Best Treated With Dynamic Anterior Stabilization for On-Track Lesions and with Remplissage for Off-Track Lesions

医学 尸体痉挛 Bankart修复 运动范围 前肩 磁道(磁盘驱动器) 肩膀 肱二头肌 班卡病损 外科 核医学 操作系统 计算机科学
作者
Chenliang Wu,Zipeng Ye,Sung Y. Lu,Zhaoyi Fang,Junjie Xu,Jinzhong Zhao
出处
期刊:Arthroscopy [Elsevier BV]
被引量:1
标识
DOI:10.1016/j.arthro.2024.01.023
摘要

Purpose

To compare the biomechanical effects of augmenting Bankart repair (BR) with either remplissage or dynamic anterior stabilization (DAS) in the treatment of anterior shoulder instability with on-track or off-track bipolar bone loss.

Methods

Eight fresh-frozen cadaveric shoulders were tested at 60° of glenohumeral abduction in the intact, injury, and repair conditions. Injury conditions included 15% glenoid bone loss with an on-track or off-track Hill–Sachs lesion as previously recommended. Repair conditions included isolated BR, BR with remplissage, and BR with DAS (long head of biceps transfer). The glenohumeral stability was assessed by measuring the anterior translation under 0, 10, 20, 30, 40, 50 N load and maximum load without causing instability at mid-range (60°) and end-range (90°) external rotation (ER). Maximum range of motion (ROM) was measured by applying a 2.2-N·m torque in passive ER and internal rotation.

Results

Isolated BR failed to restore native glenohumeral stability in both on-track and off-track bipolar bone loss models. Both remplissage and DAS significantly decreased the anterior instability in the bipolar bone loss models, showing better restoration than the isolated BR. In the on-track lesions, DAS successfully restored native glenohumeral stability and mobility, whereas remplissage significantly decreased anterior translation without load (–2.12 ± 1.07 mm at 90° ER, P = .003; –1.98 ± 1.23 mm at 60° ER, P = .015). In the off-track lesions, remplissage restored native glenohumeral stability but led to significant ROM limitation (–8.6° ± 2.3° for internal rotation, P < .001; –13.9° ± 6.2° for ER, P = .003), whereas DAS failed to restore native stability at 90° ER regarding the increased anterior translation under 50 N (4.10 ± 1.53 mm, P < .001) and decreased maximum load (–13.8 ± 9.2 N, P = .021).

Conclusions

At time-zero, both remplissage and DAS significantly reduced residual anterior instability compared with isolated BR in the bipolar bone loss models and restored the native glenohumeral stability under most translational loads. However, remplissage could decrease the anterior translation without load for on-track lesions and may restrict ROM for off-track lesions, whereas DAS failed to restore native stability under high translational loads for off-track lesions.

Clinical Relevance

DAS could be recommended to treat on-track bipolar bone loss with less biomechanical adverse effects, whereas remplissage might be the preferred procedure to address off-track bipolar bone loss for better stability.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
我嘞个豆完成签到,获得积分10
1秒前
Ayao发布了新的文献求助10
1秒前
彭于晏应助RNAPW采纳,获得10
2秒前
3秒前
5秒前
6秒前
6秒前
路漫漫123完成签到,获得积分10
7秒前
英俊的铭应助温暖的以旋采纳,获得10
7秒前
量子星尘发布了新的文献求助10
8秒前
大白发布了新的文献求助20
8秒前
9秒前
ZZ发布了新的文献求助10
9秒前
马马发布了新的文献求助10
9秒前
Ss发布了新的文献求助30
9秒前
上官若男应助Nnn采纳,获得100
10秒前
11秒前
木火灰完成签到,获得积分10
11秒前
11秒前
丸丸发布了新的文献求助10
12秒前
13秒前
Ayao完成签到,获得积分10
14秒前
slx0410完成签到,获得积分10
14秒前
小紫完成签到,获得积分10
14秒前
15秒前
今后应助小小橙采纳,获得10
15秒前
SciGPT应助科研通管家采纳,获得10
15秒前
SYLH应助科研通管家采纳,获得10
15秒前
Owen应助科研通管家采纳,获得10
15秒前
SYLH应助科研通管家采纳,获得30
15秒前
在水一方应助马马采纳,获得10
15秒前
FashionBoy应助科研通管家采纳,获得10
16秒前
烟花应助末末采纳,获得10
16秒前
领导范儿应助科研通管家采纳,获得10
16秒前
16秒前
SYLH应助科研通管家采纳,获得30
16秒前
小二郎应助科研通管家采纳,获得10
16秒前
CodeCraft应助科研通管家采纳,获得10
16秒前
FashionBoy应助科研通管家采纳,获得10
16秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3975816
求助须知:如何正确求助?哪些是违规求助? 3520159
关于积分的说明 11201128
捐赠科研通 3256541
什么是DOI,文献DOI怎么找? 1798347
邀请新用户注册赠送积分活动 877539
科研通“疑难数据库(出版商)”最低求助积分说明 806426