Arthroskopische Rekonstruktion der Subscapularissehne

Obere Extremität - Tập 6 - Trang 24-34 - 2011
J.D. Agneskirchner1, L. Lafosse2, P. Kasten3
1Sportsclinic Germany, Hannover, Deutschland
2Alps Surgery Institute, Clinique Generale, Annecy, Frankreich
3Klinik für Orthopädie, Universitätsklinikum Carl Gustav Carus, Dresden, Dresden, Deutschland

Tóm tắt

Verletzungen der Subscapularissehne werden klinisch häufig übersehen. Relevante Rupturen haben allerdings eine erhebliche und nicht kompensierbare Dezentrierung und Funktionseinschränkung der Schulter zu Folge. Spezifische klinische Tests und moderne Schnittbildgebung führen zur Diagnose und präoperativen Klassifikation. Die Arthroskopie ermöglicht eine präzise Diagnostik und Klassifikation der Sehnenläsionen, wobei neben der intraartikulären Beurteilung bei höhergradigen Rupturen auch eine extraartikuläre Visualisierung der Subscapularissehne und der benachbarten Strukturen erforderlich ist. Die arthroskopische Rekonstruktion von Subscapularissehnenrupturen setzt nicht nur ein präzises anatomisches Verständnis und fortgeschrittene arthroskopische Fertigkeiten voraus, sondern sie erfordert neben der Technik der Refixation vor allem ein suffizientes Release der Sehnenstrukturen. Angaben zu Resultaten nach arthroskopischer Refixation sind in der Literatur noch spärlich vorhanden. Unter Beachtung der Klassifikation und der damit verbundenen Indikationsgrenzen lassen sich nach eigener Erfahrung gute Ergebnisse erzielen.

Tài liệu tham khảo

Adams CR, Schoolfield JD, Burkhart SS (2008) The results of arthroscopic subscapularis tendon repairs. Arthroscopy 24(12):1381–1389 Barth JR, Burkhart SS, De Beer JF (2006) The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy 22:1076–1084 Bartsch M, Greiner S, Haas NP, Scheibel M (2010) Diagnostic values of clinical tests for subscapularis lesions. Knee Surg Sports Traumatol Arthrosc 18(12):1712–1717 Bennett WF (2003) Arthroscopic repair of isolated subscapularis tears: A prospective cohort with 2- to 4-year follow-up. Arthroscopy 19:131–143 Burkhart SS, Brady PC (2006) Arthroscopic subscapularis repair: surgical tips and pearls A to Z. Arthroscopy 22:1014–1027 Burkhart SS, Tehrany AM (2002) Arthroscopic subscapularis tendon repair: technique and preliminary results. Arthroscopy 18:454–463 Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 160–164 Deutsch A, Altchek DW, Veltri DM et al (1997) Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med 25:13–22 Edwards TB, Walch G, Nove-Josserand L et al (2006) Arthroscopic debridement in the treatment of patients with isolated tears of the subscapularis. Arthroscopy 22:941–946 Edwards TB, Walch G, Sirveaux F et al (2005) Repair of tears of the subscapularis. J Bone Joint Surg Am 87(4):725–730 Ellman H, Hanker G, Bayer M (1986) Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am 68:1136–1144 Flury M, John M, Goldhahn J et al (2006) Rupture of the subscapularis tendon (isolated or in combination with supraspinatus tear): when is a repair indicated? J Shoulder Elbow Surg 15(6):659–664 Gerber C, Hersche O, Farron A (1996) Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 78:1015–1023 Gerber C, Krushell RJ (1991) Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br 73:389–394 Goutallier D, Postel JM, Bernageau J et al (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 78–83 Goutallier D, Postel JM, Gleyze P et al (2003) Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg 12:550–554 Hauser ED (1954) Avulsion of the tendon of the subscapularis muscle. J Bone Joint Surg Am 36-A:139–141 Kim SH, Oh I, Park JS et al (2005) Intra-articular repair of an isolated partial articular-surface tear of the subscapularis tendon. Am J Sports Med 33:1825–1830 Kreuz PC, Remiger A, Erggelet C et al (2005) Isolated and combined tears of the subscapularis tendon. Am J Sports Med 33:1831–1837 Kreuz PC, Remiger A, Lahm A et al (2005) Comparison of total and partial traumatic tears of the subscapularis tendon. J Bone Joint Surg Br 87:348–351 Lafosse L, Baier GP, Jost B (2006) Footprint fixation for arthroscopic reconstruction in anterior shoulder instability: the Cassiopeia double-row technique. Arthroscopy 22:231–231 Lafosse L, Raebroeckx A van, Brzoska R (2006) A new technique to improve tissue grip: „the lasso-loop stitch“. Arthroscopy 22(1246):e1–e3 Lafosse L, Jost B, Reiland Y et al (2007) Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am 89(7):1533–1541 Lafosse L, Reiland Y, Baier GP et al (2007) Anterior and posterior instability of the long head of the biceps tendon in rotator cuff tears: a new classification based on arthroscopic observations. Arthroscopy 23:73–80 Lafosse L, Lanz U, Saintmard B, Campens C (2010) Arthroscopic repair of subscapularis tear: surgical technique and results. Orthop Traumatol Surg Res 96 (Suppl):99–108 Nove-Josserand L, Levigne C, Noel E, Walch G (1994) Isolated lesions of the subscapularis muscle. Apropos of 21 cases. Rev Chir Orthop Reparatrice Appar Mot 80:595–601 Resch H, Povacz P, Ritter E, Matschi W (2000) Transfer of the pectoralis major muscle for the treatment of irreparable rupture of the subscapularis tendon. J Bone Joint Surg Am 82:372–382 Smith HG (1835) Pathologic appearance of seven cases of injury of the shoulder joint with remarks. Am J Med Sci 16:219–224 Symeonides PP (1972) The significance of the subscapularis muscle in the pathogenesis of recurrent anterior dislocation of the shoulder. J Bone Joint Surg Br 54:476–483 Ticker JB, Warner JJ (1997) Single-tendon tears of the rotator cuff. Evaluation and treatment of subscapularis tears and principles of treatment for supraspinatus tears. Orthop Clin North Am 28:99–116 Walch G, Nove-Josserand L, Boileau P, Levigne C (1998) Subluxations and dislocations of the tendon of the long head of the biceps. J Shoulder Elbow Surg 7:100–108 Werner A, Mueller T, Boehm D, Gohlke F (2000) The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med 28:28–31