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Arthroskopie

, Volume 32, Issue 1, pp 3–10 | Cite as

Innovationen bei der arthroskopischen Therapie der Schulterinstabilität

  • M. Holschen
  • J. D. AgneskirchnerEmail author
Leitthema
  • 128 Downloads

Zusammenfassung

Einleitung

Die arthroskopische Versorgung der glenohumeralen Instabilität unterliegt einem vielfältigen Innovationsprozess. Neben weichteiligen Stabilisierungsverfahren rücken knöcherne Augmentationen zunehmend in den Vordergrund. Diese Arbeit soll eine aktuelle Übersicht über neue Techniken und Implantate für die arthroskopische Schulterstabilisierung bieten.

Material und Methoden

Eine selektive Literaturrecherche wurde durchgeführt. Eigene Erfahrungen werden berichtet.

Ergebnisse

Für die weichteilige Schulterstabilisierung existieren mittlerweile optimierte knotenfreie Anker und minimal-invasive All-suture-Anker. Doppelreihenrekonstruktionen wurden für den Bankart-Repair und für die Remplissage von Hill-Sachs-Defekten beschrieben. Die knöcherne Stabilisierung des Schultergelenks wird zunehmend zu einer Domäne der arthroskopischen Chirurgie. Neben verbesserten Implantaten wie resorbierbaren Schrauben und versenkbaren Schrauben besteht die Möglichkeit der Fixation der knöchernen Transplantate mittels Suture-Buttons und der implantatfreien Fixation.

Schlussfolgerung

Es steht zu erwarten, dass die neuen Techniken die klinischen Ergebnisse bei der arthroskopischen Versorgung der Schulterinstabilität verbessern. Wie bei allen neueren Techniken bleiben Langzeitergebnisse allerdings abzuwarten.

Schlüsselwörter

Glenohumerale Instabilität Bankart-Repair Hill-Sachs-Defekt Glenoiddefekt Knöcherne Augmentation 

Innovations in arthroscopic treatment of shoulder instability

Abstract

Background

Arthroscopic treatment of glenohumeral instability has been influenced by numerous innovations. In addition to soft tissue stabilization procedures, bony augmentation is becoming increasingly more important. This article presents an overview of novel techniques and implants for arthroscopic shoulder stabilization.

Material and methods

A selective review of the literature was carried out and personal experiences are reported.

Results

Optimized knot-free anchors and minimally invasive all-suture anchors are now available for soft tissue shoulder stabilization. Double row reconstructions were described for Bankart repair as well as well as for remplissage of Hill-Sachs lesions. Bony stabilization of the shoulder joint plays an increasing role in the domain of arthroscopic surgery. In addition to improved implants, such as resorbable screws and countersunk screws fixation of bone grafts can be performed with suture buttons and or even without implants.

Conclusion

The new emerging techniques should lead to an improvement in the clinical results for arthroscopic treatment of shoulder instability. As for all new techniques, long-term results showing a clinical benefit are still to be awaited.

Keywords

Glenohumeral instability Bankart repair Hill-Sachs defect Glenoid defect Bony augmentation 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Holschen und J.D. Agneskirchner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Unfall- und orthopädische Chirurgie der Raphaelsklinik MünsterMünsterDeutschland
  2. 2.Orthopädische PraxisklinikMünsterDeutschland
  3. 3.Klinik für Gelenkchirurgie und Orthopädie Hannover (go:H)HannoverDeutschland

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