朋友们大家好!今天是2020年3月11日周三。欢迎您来到《听高绪仁讲肩关节那些事儿》第356期!知之者不如好之者,好之者不如乐之者。简单的事情重复做,重复的事情坚持做,坚持的事情开心做!骐骥一跃,不能十步;驽马十驾,功在不舍。锲而舍之,朽木不折;锲而不舍,金石可镂。没有天生的专家,为了我们的患者,唯有每天在一线坚韧不拔、坚持不懈地努力学习、实践、思考、分享和提升。人生没有白走的路,每一步都算数。相信持续的力量,将每天的平凡逐渐变成不平凡,只争朝夕、不负韶华,不忘努力成为一名好医生的初心! 上图:2020年3月10日星期二,膝肩髋关节关节镜与人工关节置换手术及康复专家高绪仁在徐州医科大学附属医院(徐医附院)暨徐州二院骨科膝肩髋关节专家门诊为肩关节疼痛肩袖损伤患者进行诊疗。 今天有人问我一个问题:“高主任您好!怎么在肩关节MRI磁共振上看喙肱韧带、喙盂韧带和上盂肱韧带?” 这是一个非常好的问题! 意大利莫里斯大学(University of Molise)的Marcello Zappia1在2017年的骨骼影像学杂志上发表了一篇文章:Imaging of the coracoglenoid ligament: a third ligament in the rotator interval of the shoulder(喙盂韧带的影像学:肩关节肩袖间隙的第三根韧带)。 Marcello Zappia将喙盂韧带( coracoglenoid ligament:CGL)、盂肱上韧带(superior glenohumeral ligament :SGHL)和喙肱韧带(coracohumeral ligament:CHL)的复合体根据不同的解剖变异分成6种类型。并通过加了造影剂的磁共振影像为我们做了清晰的展示。值得我们学习。 I型:清晰的喙盂韧带型。这一种情况下喙盂韧带、盂肱上韧带、喙肱韧带都显示的很清楚。 II型:L型。此型喙盂韧带和喙肱韧带都显示的非常清楚,但是上盂肱韧带和其他两根韧带融合在一起了,显示的不清楚。 III型:上盂肱韧带/喙盂韧带部分融合型。此型喙盂韧带显示的很清楚,但是显示的和上盂肱韧带近端融合在一起。 IV型:喙盂韧带-上盂肱韧带-喙肱韧带三者复合型。此型是三个韧带显示像一个比较粗的结构。三根韧带不能分别开。 V型:喙盂韧带缺失型。影像学上显示喙盂韧带的位置被造影剂或脂肪所取代。 VI型:韧带辨识不清型。此型怎么都看不清楚韧带。 上图: I型:清晰的喙盂韧带型。 II型:L型。 III型:上盂肱韧带/喙盂韧带部分融合型。 IV型:喙盂韧带-上盂肱韧带-喙肱韧带三者复合型。 V型:喙盂韧带缺失型。 VI型:韧带辨识不清型。 他山之石,可以攻玉。勤学苦练,造福患家。 “借问肩痛去哪里,路人遥指高绪仁”。全国各地肩关节损伤患者,如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科高绪仁膝肩髋关节医疗组 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 已致力于膝肩髋关节疼痛的诊断、治疗、康复、医教研、科普宣教、社会服务22年 参考文献 Zappia M,Castagna A,Barile A,et al.Imaging of the coracoglenoid ligament: a third ligament in the rotator interval of the shoulder.Skeletal Radiol. 2017 Aug;46(8):1101-1111. Arai, R., Nimura, A., Yamaguchi, K. et al. The anatomy of the coracohumeral ligament and its relation to the subscapularis muscle. J Shoulder Elbow Surg. 2014; 23: 1575–1581 Ozaki, J., Nakagawa, Y., Sakurai, G., and Tamai, S. Recalcitrant chronic adhesive capsulitis of the shoulder. Role of contracture of the coracohumeral ligament and rotator interval in pathogenesis and treatment. J Bone Joint Surg Am. 1989; 71: 1511–1515 Koide, M., Hamada, J., Hagiwara, Y., Kanazawa, K., and Suzuki, K. A thickened coracohumeral ligament and superomedial capsule limit internal rotation of the shoulder joint: Report of three cases. Case Rep Orthop. 2016; 2016: 9384974 Kanazawa, K., Hagiwara, Y., Kawai, N. et al. Correlations of coracohumeral ligament and range of motion restriction in patients with recurrent anterior glenohumeral instability evaluated by magnetic resonance arthrography. J Shoulder Elbow Surg. 2017; 26: 233–240 Clark, J.M. and Harryman, D.T. II. Tendons, ligaments, and capsule of the rotator cuff. Gross and microscopic anatomy. J Bone Joint Surg Am. 1992; 74: 713–725 Rahu M, Kolts I, Põldoja E, Kask K.Rotator cuff tendon connections with the rotator cable.Knee Surg Sports Traumatol Arthrosc. 2017 Jul;25(7):2047-2050. 高绪仁 冻结肩的核磁共振研究:喙肱韧带(coracohumeral ligament,CHL) http://blog.sciencenet.cn/blog-394169-609267.html 高绪仁 喙肱韧带松解能减少肩袖损伤修复手术后外旋功能受限么? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1201933 高绪仁 肩关节喙突上主要有哪些韧带、肌腱附着呀? https://www.sohu.com/a/279608306_100281680 高绪仁 肩关节喙突上主要有哪些韧带、肌腱附着呀? http://wap.sciencenet.cn/home.php?mod=spacedo=blogid=1149674 高绪仁 肩关节盂肱上韧带在哪里? http://blog.sciencenet.cn/blog-394169-1168453.html 高绪仁 肩关节盂肱中韧带在哪里? https://www.sohu.com/a/303129225_100281680 关键词:肩关节 喙肱韧带 喙盂韧带 上盂肱韧带 磁共振解剖 高绪仁 肩关节疼痛 肩膀疼 肩膀痛 怎么办 怎么治疗 肩关节疼痛的原因 肩膀疼肩痛不等于肩周炎 肩周炎 冻结肩 肩关节粘连 肩关节损伤 肩关节骨折 肱骨近端骨折 肩胛骨骨折 肩胛盂骨折 肩关节脱位 肩关节不稳 肩锁关节损伤 肩袖损伤 盂唇损伤 SLAP损伤 Bankart损伤 肱二头肌长头腱 肩关节撞击征 肩峰下撞击征 炎症 损伤 撕裂 肱骨头坏死 肩关节镜微创手术 反式人工肩关节及置换手术 康复锻炼指导 中国 江苏 徐州 肩关节专家 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2020年3月1日周日。欢迎您来到《听高绪仁讲肩关节那些事儿》第333期!知之者不如好之者,好之者不如乐之者。简单的事情重复做,重复的事情坚持做,坚持的事情开心做!骐骥一跃,不能十步;驽马十驾,功在不舍。锲而舍之,朽木不折;锲而不舍,金石可镂。没有天生的专家,为了我们的患者,唯有每天在一线坚韧不拔、坚持不懈地努力学习、实践、思考、分享和提升。相信持续的力量,将每天的平凡逐渐变成不平凡,只争朝夕、不负韶华,不忘努力成为一名好医生的初心! 上图:2020年2月28日周五,膝肩髋关节关节镜与人工关节置换手术及康复专家高绪仁在徐州医科大学附属医院(徐医附院)暨徐州二院骨科膝肩髋关节专家门诊为肩关节疼痛肩袖损伤患者诊疗。 今天有人问我一个问题:“高主任您好!美国肩肘医师学会在2020美国骨科医师年会AAOS上的专题日将讨论肩关节哪些话题?” 这是一个非常好的问题! 2020年美国骨科医师年会将于2020年3月24日周二至3月28日周六(共5天)在美国弗罗里达周奥兰多举办。预计参会人员超过2万人。届时世界各地的骨科医师将去参加。这也是世界骨科界的盛会。里面的内容值得我们学习。 那么第五天,2020年3月28日周六,关于肩关节问题主要安排了哪些专题演讲和讨论呢? 美国肩肘医师学会将于2020年3月28日周六在2020美国骨科医师年会上办一个学会专题研讨会日。关于肩关节的研讨话题也非常精彩。 大师云集,精彩纷呈! 8:00-8:05 致欢迎词 Moderator主持人 会议主席 Frank A Cordasco, MD, FAAOS, New York, NY 上图:Frank A. Cordasco美国纽约特种外科医院膝/肩关节运动损伤手术专家,2018年至2019年美国肩肘外科医师学会主席。 8:05-8:22 肩关节专题一:胸大肌肌腱撕裂 Moderator主持人 Travis C Burns, MD, FAAOS, San Antonio, TX 上图:美国人工肩关节置换与肩关节关节镜手术专家 Travis C Burns。 Moderator主持人 Stephen A Parada, MD, FAAOS, Augusta, GA 上图:美国人工肩关节置换与肩关节关节镜手术专家 Stephen A Parada。 Chronic Tears – Allograft Reconstruction? 慢性撕裂---同种异体重建 John M. Itamura, MD, FAAOS, Los Angeles, CA 上图:美国洛杉矶著名肩肘关节手术专家John M. Itamura。 Musculotendinous Junction Tears – Can We Still Repair 肌肉肌腱连接处撕裂---我们仍旧能够修复么? Matthew A. Posner, MD, FAAOS, West Point, NY 肩关节不稳小专题研讨会 Moderator主持人 Jonathan F Dickens, MD, FAAOS, Bethesda, MD 上图:美国骨科运动医学专家Jonathan F Dickens擅长肩关节损伤肩关节镜手术 Paper #1: The Bristow-Latarjet Procedure for Revision of Failed Arthroscopic Bankart 肩关节镜下Bankart损伤后失效后Bristow-Latarjet手术翻修 Pascal Boileau, MD, Nice, France 上图:法国人工肩关节置换手术与肩关节关节镜手术三剑客之一Pascal Boileau。 Paper #2: Clinical and Radiographic Outcomes After Arthroscopic Iliac Bone Grafting for Traumatic Anterior Shoulder Instability with Significant Glenoid Bone Loss - A Minimum of 5-Year Follow-Up 对于有明显肩胛骨骨缺损的肩关节前向不稳患者采用肩关节镜下髂骨块移植的临床及影像学效果:至少5年的随访结果 Yusuke Ueda, MD, Tokyo, Japan Case-Based Discussion I: 18-Year Old Marine with 2nd Dislocation and 14% Glenoid Bone Loss 基于病例的讨论环节:18岁的海军陆战队士兵,第二次肩关节脱位,14%肩胛盂骨缺损 Arthroscopic Repair is Just Fine 肩关节镜下修复就好了 Craig R. Bottoni, MD, FAAOS, HONOLULU, HI 上图:美国夏威夷三军医学中心骨科肩关节专家Craig R. Bottoni。 Does Anyone Remember How to Do an Open Bankart? 还有谁记得怎么做切开Bankart损伤修复手术吗? Bradley J. Nelson, MD, FAAOS, Minneapolis, MN 上图:美国明尼苏达骨科运动医学与肩关节手术专家Bradley J. Nelson。 Fix It Right the First Time - Latarjet 第一次就把它固定好-Latarjet手术 Thomas B. Edwards, MD, FAAOS, Houston, TX 肩关节讨论第2个小专题:年轻患者肩关节骨关节炎 Moderator主持人 Josef Karl Eichinger, MD, FAAOS, Charleston, SC 上图:美国人工肩关节置换与肩关节关节镜手术专家Josef Karl Eichinger Moderator主持人 Kelly G Kilcoyne, MD, FAAOS, Bethesda, MD Case-Based Discussion II: 35-Year Old Male Soldier/Weightlifter with B2Glenoid and 'Labral Tear' 基于病例的讨论II:35岁男性,士兵/举重运动员。B2型肩胛盂,盂唇撕裂。 Paper #3: Midterm (= 5 Year) Outcomes for Biologic Resurfacing of the Glenoid Are Satisfactory for Patients Aged =60 Years with Glenohumeral Osteoarthritis 生物表面处理肩胛盂对于年龄=60岁的盂肱关节骨关节炎患者中期(= 5 年)临床随访效果是满意的 Armodios M. Hatzidakis, MD, FAAOS, Denver, CO 上图:美国肩肘关节专家Armodios M. Hatzidakis。 Use the Sniper Rifle - Arthroscopic Options 用小枪:关节镜的应用 Felix H. Savoie III, MD, FAAOS, New Orleans, LA 上图:美国新奥尔良著名肩关节专家Felix H. Savoie III。 Go Big Guns - TSA is the Way 用大炮:人工肩关节置换是一个选择 Glen Rose,MD 肩关节小专题讨论II:不可修复的肩袖损伤 Moderator主持人 Joseph A Abboud, MD, FAAOS, Philadelphia, PA 上图:美国Rothman骨科研究所肩肘关节手术专家Joseph A Abboud。 Moderator主持人 Lawrence V Gulotta, MD, FAAOS, New York, NY 上图:美国纽约特种外科医院运动医学科肩肘关节组组长Lawrence V Gulotta。精通肩关节关节镜手术和肩关节切开手术。 Paper #4: Arthroscopic Superior Capsule Reconstruction: Comparison of Clinical Outcome with and Without Subscapularis Tear 肩关节镜下上关节囊重建:比较有何无肩胛下肌肌腱撕裂的临床效果 Teruhisa Mihata, MD, PhD, Takatsuki, Osaka, Japan 上图:日本大阪肩关节上关节囊重建治疗巨大肩袖撕裂著名专家Teruhisa Mihata (三幡 輝久) 。 Paper #5: Mid-Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients Age 75 and Older 肩关节镜下修复75岁以上高龄肩袖撕裂的中期临床疗效 Surena Namdari, MD, MSc, Philadelphia, PA 上图:美国Rothman骨科研究所肩关节手术专家Surena Namdari。 Case-Based Discussion III: 58-Year Old Female Hairdresser with Massive Unreducible Chronic Cuff Tear 基于病例的专题讨论III:58岁女性,美发师,巨大不可修复慢性肩袖撕裂 Arthroscopic SCR is the Way to Go 肩关节镜下上关节囊重建手术是一个可行的办法 John M. Tokish, MD, FAAOS, Scottsdale, AZ 上图:美国前全军骨科医师学会会长、前北美关节镜学会主席,肩关节手术专家John M. Tokish。 Reverse is Always the Answer! 反肩置换永远是这个问题的答案! Mark A. Frankle, MD, FAAOS, Temple Terrace, FL 上图:美国弗罗里达骨科研究所人工肩关节置换手术专家Mark A. Frankle。 Tendon Transfer, Has the Trapezius Taken Over? 肌腱转位,斜方肌转位可以雄霸江湖了么? Bassem T. Elhassan, MD, FAAOS, Rochester, MN 上图:美国梅奥医学中心骨科肩肘关节手术专家Bassem T. Elhassan。 肩关节专题研讨III:投掷运动员 Moderator主持人 John E Conway, MD, FACS, FAAOS, Fort Worth, TX Moderator主持人 W Benjamin Kibler, MD, FAAOS, Lexington, KY Paper #6: Magnetic Reasonance Imaging Findings of the Asymptomatic Shoulder Predict Injuries and Surgery in Major League Baseball Pitchers 通过肩关节无症状的大联盟棒球投手的肩关节磁共振预测今后损伤和手术的可能 Gregory P. Nicholson, MD, FAAOS, Chicago, IL Paper #7: Osteochondral Autograft Transportation vs Arthroscopic Fragment Resection for Large Capitellar Osteochondritis Dissecans in Adolescent Athletes - a Minimum of 5-Year Follow-Up 自体骨软骨移植VS关节镜下碎片摘除治疗青少年运动员肘关节骨软骨剥脱性骨软骨炎:一项至少5年的随访研究 Yusuke Ueda, MD, Tokyo, Japan The Type 2 SLAP Tear – Ought We Treat Our 18-Year-Old like the 35-Year-Old Professional? 2型SLAP损伤---我们治疗18岁的和35岁的职业运动员方法应该一样么? John E. Conway, MD, FACS, Fort Worth, TX UCL Surgery in 2020 2020年的尺侧副韧带手术 Michael G. Ciccotti, MD, FAAOS, Philadelphia, PA Everything You Need to Learn about Throwing Injuries in a Single Major League Career 您需要了解的棒球职业生涯中的投掷损伤 David W. Altchek, MD, FAAOS, New York, NY Heinz R. Hoenecke JR, MD, FAAOS, La Jolla, CA Neer奖颁发及演讲 主持人:Frank A. Cordasco,MD,MS,2018年至2019年美国肩肘外科医师学会主席 上图:Frank A. Cordasco美国纽约特种外科医院膝/肩关节运动损伤手术专家,2018年至2019年美国肩肘外科医师学会主席。 肩关节专题研讨IV:人工肩关节置换手术 Moderator主持人 Joseph P Iannotti, MD, PhD, FAAOS, Delray Beach, FL 上图:美国著名肩关节专家Joseph P Iannotti。 Moderator主持人 James D Kelly II, MD, FAAOS, San Francisco, CA 上图:美国著名人工肩关节置换手术专家James D Kelly II。 Paper #8: Three-Dimensional Computed Tomography Analysis of Glenoid Component Shift and Osteolysis Following Total Shoulder Arthroplasty 三维CT分析人工肩关节置换手术后肩胛盂侧假体移位和骨溶解 Eric T. Ricchetti, MD, FAAOS, Cleveland, OH Paper #9: Does Stemless Shoulder Arthroplasty Stand the Test of Time? 9-13 Year Results - A Prospective Study 无栟人工肩关节置换能够经得起时间的检验吗?9到13年的结果-一个前瞻性研究 Sven Lichtenberg, MD, Heidelberg, Germany Preoperative Templating: Is There a Gold Standard? 术前模板:有金标准么? Joseph P. Iannotti, MD, PhD, Weston, FL Case-Based Discussion IV: Arthroplasty Decision Making for a B2 Glenoid 基于病例的讨论IV:对于B2型肩胛盂的人工肩关节置换手术的考量 Case Presentation 病例展示 James D. Kelly II, MD, FAAOS, San Francisco, CA 3D Planning Solution #1 三维术前设计解决方案1 Charles M. Jobin, MD, FAAOS, New York, NY 3D Planning Solution #2 三维术前设计解决方案2 Edward R. Hobgood, MD, FAAOS, Jackson, MS 3D Planning Solution #3 三维术前设计解决方案3 Eric T. Ricchetti, MD, FAAOS, Cleveland, OH Case-Based Discussion V: Arthroplasty for Severe Glenoid Deficiency 基于病例的讨论V:严重肩胛盂骨缺损的人工肩关节置换翻修手术 Revision with Distal Clavicle Autograft 用自体远端锁骨移植物进行翻修 James D. Kelly II, MD, FAAOS, San Francisco, CA Revision Using a Custom Glenoid Implant 用定制式肩胛盂假体进行翻修 John M. Itamura, MD, FAAOS, Los Angeles, CA 他山之石,可以攻玉。勤学苦练,造福患家。 “借问肩痛去哪里,路人遥指高绪仁”。全国各地肩关节损伤患者,如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科高绪仁膝肩髋关节医疗组 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 参考文献 2020年美国AAOS骨科医师年会会议日程 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月24周二肩关节会场是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221019 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月25日周三是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221086 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月26日周四是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221091 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月27日周五是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221097 高绪仁 美国骨科运动医学会及北美关节镜学会在2020美国骨科医师年会上的专题日将讨论肩关节哪些话题? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221191 关键词:美国骨科医师年会 2020 美国肩肘医师学会 肩关节 高绪仁 肩关节疼痛 肩关节疼痛的 原因 肩膀疼肩痛不等于肩周炎 肩周炎 冻结肩 肩关节粘连 肩关节损伤 肩关节骨折 肱骨近端骨折 肩胛骨骨折 肩胛盂骨折 肩关节脱位 肩关节不稳 肩锁关节损伤 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 反式人工肩关节及置换手术 中国 江苏 徐州 肩关节专家 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2020年3月1日周日。欢迎您来到《听高绪仁讲肩关节那些事儿》第332期!知之者不如好之者,好之者不如乐之者。简单的事情重复做,重复的事情坚持做,坚持的事情开心做!骐骥一跃,不能十步;驽马十驾,功在不舍。锲而舍之,朽木不折;锲而不舍,金石可镂。没有天生的专家,为了我们的患者,唯有每天在一线坚韧不拔、坚持不懈地努力学习、实践、思考、分享和提升。相信持续的力量,将每天的平凡逐渐变成不平凡,只争朝夕、不负韶华,不忘努力成为一名好医生的初心! 上图:2020年2月28日周五,膝肩髋关节关节镜与人工关节置换手术及康复专家高绪仁在徐州医科大学附属医院(徐医附院)暨徐州二院骨科膝肩髋关节专家门诊为肩关节疼痛肩袖损伤患者诊疗。 今天有人问我一个问题:“高主任您好!美国骨科运动医学会及北美关节镜学会在2020美国骨科医师年会AAOS上的专题日将讨论肩关节哪些话题?” 这是一个非常好的问题! 2020年美国骨科医师年会将于2020年3月24日周二至3月28日周六(共5天)在美国弗罗里达周奥兰多举办。预计参会人员超过2万人。届时世界各地的骨科医师将去参加。这也是世界骨科界的盛会。里面的内容值得我们学习。 那么第五天,2020年3月28日周六,关于肩关节问题主要安排了哪些专题演讲和讨论呢? 美国骨科运动医学会及北美关节镜学会将于2020年3月28日周六在2020美国骨科医师年会上办一个学会专题研讨会日。关于肩关节的研讨话题也非常精彩。 大师云集,精彩纷呈! 上图:美国骨科运动医学会及北美关节镜学会专题研讨会日:肩关节讨论的话题。 7:00-7:05 致欢迎词 课程主席 Lee D.Kaplan Kevin F. Bonner 7:05-8:20 第一部分:肩关节不稳/盂唇 Moderator Mary Lloyd Ireland, MD, FAAOS, Lexington, KY Moderator Brian R Waterman, MD, FAAOS, Winston Salem, NC 主持人:Mary Lloyd Ireland和Brian R Waterman Paper #1: Revision Arthroscopic Bankart Repair in the Military 军人关节镜下Bankart损伤修复手术后翻修手术 Jonathan F. Dickens, MD, FAAOS, Bethesda, MD Paper #2: Surgical Outcomes in the Frequency, Etiology, Direction, Severity (feds) Classification System for Shoulder Instability 基于EEDS(发生率、原因、方向、严重程度)的肩关节不稳的手术效果 Carolyn Hettrich, MD, MPH, Boston, MA Questions and Answers 问答环节 My Pearls to Successful Arthroscopic Shoulder Stabilization 我关节镜下治疗肩关节不稳的手术诀窍 Claude T. Moorman III, MD, FAAOS, Charlotte, NC My Tricks to a Reproducible Safe Laterjet 我做Laterjet手术可重复性高、效果好的绝招 Matthew T. Provencher, MD MC USNR, Vail, CO Debate: 22-Year-Old Recreational Male Athlete Sustains 4th Anterior Dislocation: 15% Glenoid Bone Loss / Hill-Sachs Lesion 辩论环节:22岁男性,休闲运动运动员,第4次肩关节前脱位:15%的肩胛盂骨缺损/Hill-Sachs损伤 Moderator:主持人 Paul E. Caldwell III, MD, FAAOS, Richmond, VA Arthroscopic Stabilization with Remplissage: Listen Why 肩关节镜下稳定手术合并Remplissage加强:听听我为什么这么做 John D. Kelly IV, MD, FAAOS, Newtown Square, PA Laterjet: No Second Thoughts Laterjet手术:不二之选,毋庸置疑 Anthony A. Romeo, MD, FAAOS, New York City, NY Paper #3: Risk Factors for Revision Posterior Shoulder Stabilization in Throwing Athletes 投掷运动员后向肩关节不稳晚修的危险因素 Ravi S. Vaswani, MD, Pittsburgh, PA Return to Sport Following Shoulder Stabilization: As Good as We Think? 肩关节不稳手术后返回运动:能像我们想象的那么好么? Scott A. Rodeo, MD, FAAOS, New York, NY Questions and Answers 问答环节 Shoulder Instability Case Panel: Rapid Fire – What Would You Do? 肩关节不稳病例讨论环节:Rapid Fire——-您怎么看?您怎么办? Moderator and Panelists 主持人及专家讨论团队 William N. Levine, MD, FAAOS, New York, NY Anthony A. Romeo, MD, FAAOS, New York City, NY Claude T. Moorman III, MD, FAAOS, Charlotte, NC Paul E. Caldwell III, MD, FAAOS, Richmond, VA Matthew T. Provencher, MD MC USNR, Vail, CO John D. Kelly IV, MD, FAAOS, Newtown Square, PA Scott A. Rodeo, MD, FAAOS, New York, NY Questions and Answers 问答环节 8:20-8:59 第二部分:肩关节肱二头肌长头腱、肩胛骨、肩锁关节 Moderator主持人 Joseph C Tauro, MD, FAAOS, Toms River, NJ Moderator主持人 Dean C Taylor, MD, FAAOS, Durham, NC Evaluation and Approach to the Thrower’s Shoulder 投掷运动员肩关节病损的评估方法和治疗方法 Neal S. ElAttrache, MD, FAAOS, Los Angeles, CA SLAP Repair vs. Tenodesis – How to Make the Right Call? SLAP损伤修复还是肌腱固定术——-如何做决定? John E. Conway, MD, FAAOS, Fort Worth, TX Paper #4: Radiostereometric Analysis of Biceps Tenodesis: A Comparison of Techniques 放射立体照相测量分析肱二头肌长头腱腱固定术:各种方法的比较 Adam B. Yanke, MD, FAAOS, Chicago, IL Biceps Tenodesis: How I Do This and Why? 肱二头肌长头腱固定术:我如何做的?我为什么这么做? Alan S. Curtis, MD, FAAOS, Weston, MA The Unstable AC Joint – Fixing and Avoiding Complications 肩锁关节不稳:固定、避免并发症 Stephen F. Brockmeier, MD, FAAOS, Charlottesville, VA 8:59-9:40 肩关节第3部分 Moderator主持人 Mark H Getelman, MD, FAAOS, Thousand Oaks, CA Moderator主持人 Richard K N Ryu, MD, FAAOS, Santa Barbara,CA My Five Arthroscopic Cuff Repair Tips to Make Your Life Simple 我的5个肩关节镜下肩袖修复的绝招 Peter J. Millett, MD, MSc, Vail, CO SCR Debate: 52-Year-Old Male with a Massive Cuff Tear 上关节囊重建辩论:52岁女性,巨大肩袖撕裂 主持人Richard K. Ryu, MD, FAAOS, Santa Barbara, CA Debate:Jury Still Out: Fix What You Can and Avoid an SCR 辩论:还没有定论:固定你能固定的,避免上关节囊重建 Felix H. Savoie III, MD, FAAOS, New Orleans, LA Results Justify: Why I’m Doing a SRC 疗效证明可行:为什么我在进行上关节囊重建 John M. Tokish, MD, FAAOS, Scottsdale, AZ Paper #5: Clinical and MRI Outcomes After Arthroscopic Superior Capsule Reconstruction with Human Dermal Allograft for Irreparable Posterosuperior Rotator Cuff Tears a Minimum Two-Year Follow-up 对于不可修复的后上方肩袖撕裂用人真皮异体移植物肩关节镜下上关节囊重建手术后至少2年以上的临床及影像学效果 Lucca Lacheta, MD, Vail, CO Biologics for the Cuff – What’s the Highest-Level Evidence Say? 促进肩袖愈合的生物学制剂---最高水平的证据说了什么? Brian J. Cole, MD, MBA, Chicago, IL Kennedy Lecture Kennedy专题大师演讲 演讲人:Champ L. Baker Jr,MD 上图:Champ L. Baker, Jr., MD 他山之石,可以攻玉。勤学苦练,造福患家。 “借问肩痛去哪里,路人遥指高绪仁”。全国各地肩关节损伤患者,如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科高绪仁膝肩髋关节医疗组 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 参考文献 2020年美国AAOS骨科医师年会会议日程 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月24周二肩关节会场是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221019 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月25日周三是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221086 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月26日周四是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221091 高绪仁 2020年美国骨科医师年会AAOS肩关节会场3月27日周五是怎么总体安排的? http://blog.sciencenet.cn/home.php?mod=spaceuid=394169do=blogid=1221097 关键词:美国骨科医师年会 2020 AAOS 肩关节 高绪仁 肩关节疼痛 肩关节疼痛的 原因 肩膀疼肩痛不等于肩周炎 肩周炎 冻结肩 肩关节粘连 肩关节损伤 肩关节骨折 肱骨近端骨折 肩胛骨骨折 肩胛盂骨折 肩关节脱位 肩关节不稳 肩锁关节损伤 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 反式人工肩关节及置换手术 中国 江苏 徐州 肩关节专家 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2020年2月1日周六。欢迎您来到《听高绪仁讲肩关节那些事儿》第273期!知之者不如好之者,好之者不如乐之者。简单的事情重复做,重复的事情坚持做,坚持的事情开心做!骐骥一跃,不能十步;驽马十驾,功在不舍。锲而舍之,朽木不折;锲而不舍,金石可镂。没有天生的专家,为了我们的患者,唯有每天坚韧不拔、坚持不懈地努力学习、实践和提升。相信持续的力量,将每天的平凡逐渐变成不平凡,只争朝夕、不负韶华! 上图:膝肩髋关节关节镜与人工关节置换手术及康复专家高绪仁在徐州医科大学附属医院(徐医附院)暨徐州二院骨科关节外科住院部医生办公室研究肩关节。 今天有人问我一个问题:“高主任您好!2020年2月份的《美国运动医学杂志》(IF:6.093)上关于肩关节的5篇文章主要讲了什么?” 这是一个非常好的问题! 美国运动医学杂志是世界上运动医学杂志里影响因子最高的杂志。每月一期,每期都值得我们仔细研读。 Associations of Preoperative Patient Mental Health and Sociodemographic and Clinical Characteristics With Baseline Pain, Function, and Satisfaction in Patients Undergoing Rotator Cuff Repairs Sambit Sahoo , MD, PhD , Eric T. Ricchetti , MD , Alexander Zajichek , MS , Cleveland Clinic Shoulder Group , Peter J. Evans , MD , Lutul D. Farrow , MD , Brett W. McCoy , MD , Morgan H. Jones , MD , Anthony A. Miniaci , MD , Vani J. Sabesan , MD , Mark S. Schickendantz , MD , William H. Seitz , MD , Kurt P. Spindler , MD , Kim L. Stearns , MD , Greg Strnad , MS , Alparslan Turan , MD , Vahid Entezari , MD, MMSc , Peter B. Imrey , PhD , Joseph P. Iannotti , MD, PhD , Kathleen A. Derwin , PhD * First Published December 18, 2019 ; pp. 432–443 Abstract Preview | 第1篇文章:《进行肩袖损伤修复手术的患者术前患者精神状态、社会学特点临床特点与基线疼痛水平、功能情况及满意度情况之间的相关性》 肩关节疼痛和功能障碍是肩袖修复手术的常见适应症。但是和这些症状相关的因素还研究的不是非常透彻。 该文研究发现对于要进行肩袖损伤修复手术的患者来说,大的/巨大的肩袖撕裂、VR-12中的Mental Component Summary (MCS)评估心理健康相关的生活质量评分结果较低的分数及一些疾病相关因素和基线病人报告的结局评价(PROMs)具有相关性。 还需要进一步研究这些因素是否影响肩袖损伤修复后的临床疗效。 Improved Rotator Cuff Footprint Contact Characteristics With an Augmented Repair Construct Using Lateral Edge Fixation Ekaterina Urch , MD * , Charles C. Lin , MD , Yasuo Itami , MD , Nilay A. Patel , MD , Michelle H. McGarry , MS , Orr Limpisvasti , MD , Thay Q. Lee , PhD First Published December 4, 2019 ; pp. 444–449 Abstract Preview | 第2篇文章:《采用外缘加强固定方法提高肩袖足印区覆盖》 这篇文章提出在传统缝线桥技术固定中、大型肩袖撕裂的基础上。可以采用肩袖撕裂外缘加强固定的方法,可以提高腱骨接触面积并且提高抗扭转生物力学效能。这种方法有可能使得肌腱愈合进一步优化。 上图:传统经典缝线桥技术修复肩袖损伤。 上图:在传统经典缝线桥治疗肩袖损伤的基础上在外缘再加强缝合。(左图蓝线箭头处) Rotator Cuff Repair With Autologous Tenocytes and Biodegradable Collagen Scaffold: A Histological and Biomechanical Study in Sheep Björn P. Roßbach , MD * , Mehmet F. Gülecyüz , MD , Lena Kempfert , MD , Matthias F. Pietschmann , MD , Tina Ullamann , MD , Andreas Ficklscherer , MD , Thomas R. Niethammer , MD , Anja Zhang , MD , Roland M. Klar , PhD , Peter E. Müller , MD First Published December 16, 2019 ; pp. 450–459 Abstract Preview | 第3篇文章:《采用自体肌腱细胞和生物可降解胶原支架治疗肩袖损伤:一个在羊上做的组织学和生物力学实验研究》 对于骨科医生来说大的肩袖撕裂损伤仍然是一个治疗的挑战。如果能用自体肌腱细胞和生物可降解胶原支架治疗肩袖损伤缺损,那将是一个非常有价值的方向。 该研究认为使用特殊的载体再加上自体肌腱细胞是今后治疗肩袖撕裂缺损的一个新方法。 上图:左侧两个t(肌腱)之间有缺损。右侧用可带有自己肌腱细胞的可吸收胶原支架补上。 Management of Failed Proximal Biceps Surgery: Clinical Outcomes After Revision to Subpectoral Biceps Tenodesis David D. Savin , MD * , Brian R. Waterman , MD , Shelby Sumner , MPH , Catherine Richardson , BS , John Newgren , BS , Anirudh K. Gowd , MD , Anthony A. Romeo , MD First Published December 19, 2019 ; pp. 460–465 Abstract Preview | 第4篇文章:《肱二头肌长头腱手术后失败的处理:将失败后病例翻修成胸大肌下肱二头肌长头腱固定术》 对于肱二头肌长头腱-上盂唇病损的手术方法选择还有争议。手术后有的患者可能还存在疼痛,有的患者还需要翻修手术。 该文对初次肱二头肌长头腱切断固定术及单纯切断术后失败的患者进行小切口肱二头肌长头腱胸大肌下翻修固定术。 研究发现小切口肱二头肌长头腱胸大肌下翻修固定术术后疼痛VAS评分及活动评分有明显提高。 该研究发现小切口肱二头肌长头腱胸大肌下翻修固定手术的满意度为88%。 所以我们要提前告知患者不管是初次还是翻修手术,都可能存在持续的肩关节疼痛的可能。 Horizontal Instability of the Acromioclavicular Joint: A Systematic Review Gianna M. Aliberti , BA , Matthew J. Kraeutler , MD , Jeffrey D. Trojan , MS , Mary K. Mulcahey , MD § First Published April 23, 2019 ; pp. 504–510 Abstract 第5篇文章:《肩锁关节的水平不稳:一个系统评价》。 肩锁关节损伤非常常见。喙锁韧带损伤可以导致肩锁关节水平方向的不稳。但是这个不稳常常容易引起忽视或漏诊。如果忽视或漏诊,容易出现肩锁关节区域的疼痛。 这篇文章告诉我们还没有共识来告诉我们如何做好急性或慢性肩锁关节损伤后肩锁关节水平方向不稳的诊断、评估及治疗。我们今后要重视肩锁关节水平方向不稳的诊断和治疗。 “借问肩痛去哪里,路人遥指高绪仁”。如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科高绪仁膝肩髋关节医疗组 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 参考文献 1 Sahoo S,Ricchetti ET,Zajichek A,et al.Associations of Preoperative Patient Mental Health and Sociodemographic and Clinical Characteristics With Baseline Pain, Function, and Satisfaction in Patients Undergoing Rotator Cuff Repairs.Am J Sports Med. 2020 Feb;48(2):432-443. 2 Urch E,Lin CC,Itami Y, et al.Improved Rotator Cuff Footprint Contact Characteristics With an Augmented Repair Construct Using Lateral Edge Fixation.Am J Sports Med. 2020 Feb;48(2):444-449. 3 Roßbach BP,Gülecyüz MF,Kempfert L,et al.Rotator Cuff Repair With Autologous Tenocytes and Biodegradable Collagen Scaffold: A Histological and Biomechanical Study in Sheep.Am J Sports Med. 2020 Feb;48(2):450-459. 4 Savin DD,Waterman BR,Sumner S,et al.Management of Failed Proximal Biceps Surgery: Clinical Outcomes After Revision to Subpectoral Biceps Tenodesis.Am J Sports Med. 2020 Feb;48(2):460-465. 5 Aliberti GM, Kraeutler MJ, Trojan JD,et al.Horizontal Instability of the Acromioclavicular Joint: A Systematic Review.Am J Sports Med. 2020 Feb;48(2):504-510. 关键词:美国运动学杂志,肩关节,文章,论文,高绪仁 肩关节疼痛 肩关节疼痛的原因 肩膀疼肩痛不等于肩周炎 肩周炎 冻结肩 肩关节粘连 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 反式人工肩关节及置换手术 中国 江苏 徐州 肩关节专家 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2020年1月20日周一。祝您新的一年身体健康、万事如意!开卷有益!欢迎您来到《听高绪仁讲肩关节那些事儿》第257期!知之者不如好之者,好之者不如乐之者。简单的事情重复做,重复的事情坚持做,坚持的事情开心做!骐骥一跃,不能十步;驽马十驾,功在不舍。锲而舍之,朽木不折;锲而不舍,金石可镂。没有天生的专家,为了我们的患者,唯有每天坚韧不拔、坚持不懈地努力学习、实践和提升。相信持续的力量,将每天的平凡逐渐变成不平凡,只争朝夕、不负韶华! 上图:2020年1月20日周一,膝肩髋关节关节镜与人工关节置换手术及康复专家高绪仁在徐州医科大学附属医院(徐医附院)暨徐州二院骨科关节外科手术室为患者进行肩关节镜微创手术治疗肩袖损伤。 上图:2020年1月20日周一,膝肩髋关节关节镜与人工关节置换手术及康复专家高绪仁在徐州医科大学附属医院(徐医附院)暨徐州二院骨科关节外科手术室为患者进行人工关节置换手术。 今天有人问我一个问题:“高主任您好!2020年1月份的美国肩肘外科杂志主要有哪几篇文章呀?” 这是一个很好的问题。 美国肩肘外科杂志是世界上肩肘外科专家都爱看的一本杂志。每月一期,每期都值得我们仔细研读。 Editorial JSES family of journals William J. Mallon, Pierre Mansat p1 Published in issue: January 2020 Full-Text HTML PDF Shoulder肩关节部分 Autologous chondrocyte implantation for treatment of focal articular cartilage defects of the humeral head 《自体软骨细胞移植治疗肱骨头局灶性软骨缺损》 Elisabeth Boehm, Marvin Minkus, Markus Scheibel p2–11 Published online: September 20, 2019 Full-Text HTML PDF Factors associated with choice for surgery in newly symptomatic degenerative rotator cuff tears: a prospective cohort evaluation 《对新出现的有症状的退变性肩袖撕裂影响手术策略选择的因素:一个前瞻性群组评价》 Jay D. Keener, Alexander W. Aleem, Aaron M. Chamberlain, Julianne Sefko, Karen Steger-May p12–19 Published online: October 15, 2019 Full-Text HTML PDF Next-generation sequencing for diagnosis of infection: is more sensitive really better? 《用于感染诊断的新一代测序技术:更加敏感真的更好么? Allison J. Rao, Ian S. MacLean, Amanda J. Naylor, Grant E. Garrigues, Nikhil N. Verma, Gregory P. Nicholson p20–26 Published online: October 13, 2019 Full-Text HTML PDF Operative treatment of displaced midshaft clavicular fractures is not cost-effective 《手术治疗移位的锁骨中断骨折性价比不高》 Anne-Kathrine R. Sørensen, Lianna H. Hammeken, Andreas H. Qvist, Steen L. Jensen, Lars H. Ehlers p27–35 Published online: September 25, 2019 Full-Text HTML PDF Supplemental Materials Effects of self-stretching with mobilization on shoulder range of motion in individuals with glenohumeral internal rotation deficits: arandomized controlled trial 《对于盂肱关节内旋缺失的患者活动肩关节时自我牵伸的效果:一个随机对照研究》 Min-Hyeok Kang, Jae-Seop Oh p36–43 Published online: October 15, 2019 Full-Text HTML PDF Shoulder arthroplasty in patients with immunosuppression following solid organ transplantation 《固体器官移植后免疫抑制的患者的人工肩关节置换手术》 Taku Hatta, Joseph M. Statz, Eiji Itoi, Robert H. Cofield, John W. Sperling, Mark E. Morrey p44–49 Published online: August 7, 2019 Full-Text HTML PDF Return to play and performance after shoulder instability in National Basketball Association athletes 《美国职业篮球联赛NBA运动员肩关节不稳后重返运动及表现》 Yining Lu, Kelechi R. Okoroha, Bhavik H. Patel, Benedict U. Nwachukwu, James D. Baker, Alexander J. Idarraga, Brian Forsythe p50–57 Published online: August 19, 2019 Full-Text HTML PDF Clinical results of bony increased-offset reverse shoulder arthroplasty (BIO-RSA) associated with an onlay 145° curved stem in patients with cuff tear arthropathy: a comparative study 《骨性增加偏心距反式肩关节置换(BIO-RSA)合并145度弧形嵌体肱骨柄治疗肩袖撕裂关节病的临床效果:一个比较性研究》 Edoardo Franceschetti, Riccardo Ranieri, Edoardo Giovanetti de Sanctis, Alessio Palumbo, Francesco Franceschi p58–67 Published online: August 7, 2019 Full-Text HTML PDF Characteristics of functional shoulder instability 《功能性肩关节不稳的特点》 Philipp Moroder, Victor Danzinger, Nina Maziak, Fabian Plachel, Stephan Pauly, Markus Scheibel, Marvin Minkus p68–78 Published online: August 1, 2019 Open Access Full-Text HTML PDF Supplemental Materials Evaluation of cerebral oxygen perfusion during shoulder arthroplasty performed in the semi–beach chair position 《半沙滩椅位人工肩关节置换手术时的脑部氧灌足评价》 Justin H. Chan, Hector Perez, Harrison Lee, Matthew Saltzman, Guido Marra p79–85 Published online: August 9, 2019 Full-Text HTML PDF Difficulty in performing activities of daily living associated with internal rotation after reverse total shoulder arthroplasty 《反式人工肩关节置换手术后和内旋相关的日常生活不便之处》 Myung Seo Kim, Ho Yeon Jeong, Jong Dae Kim, Kyung Han Ro, Sung-Min Rhee, Yong Girl Rhee p86–94 Published online: August 16, 2019 Full-Text HTML PDF Type V superior labral anterior-posterior (SLAP) lesion in recurrent anterior glenohumeral instability 《复发性盂肱关节不稳中的V型SLAP损伤》 Amr Abdel-Mordy Kandeel p95–103 Published online: August 27, 2019 Full-Text HTML PDF Subscapularis structural integrity and function after arthroscopic Latarjet procedure at a minimum 2-year follow-up 《肩关节镜下Latarjet手术后至少2年随访时的肩胛下肌结构完整性和功能》 María Valencia, Gloria Fernández-Bermejo, María D. Martín-Ríos, Javier Fernández-Jara, Diana Morcillo-Barrenechea, Ismael Coifman-Lucena, Antonio M. Foruria, Emilio Calvo p104–112 Published online: August 10, 2019 Full-Text HTML PDF Predictors of failure after conservative treatment of symptomatic partial-thickness rotator cuff tear 《有症状的肩袖部分撕裂保守治疗的失败预测因素》 Morteza Nakhaei Amroodi, Mostafa Salariyeh p113–120 Published online: August 6, 2019 Full-Text HTML PDF Elbow 肘关节部分 Cost analysis of Tommy John surgery for Major League Baseball teams 《美国全国棒球协会棒球球队队员进行TommyJohn手术的成本效益分析》 Jason E. Meldau, Karan Srivastava, Kelechi R. Okoroha, Christopher S. Ahmad, Vasilios Moutzouros, Eric C. Makhni p121–125 Published online: October 23, 2019 Full-Text HTML PDF Long-term outcomes after Instrumented Bone Preserving total elbow arthroplasty: a radiostereometric study with a minimum follow-up of 10 years 《结构骨保留的人工全肘关节置换手术的长期临床疗效:一个至少随访10年的放射立体摄相测量分析》 Bart ten Brinke, Nienke M. Kosse, Petra E. Flikweert, Marco van der Pluijm, Denise Eygendaal p126–131 Published online: September 26, 2019 Full-Text HTML PDF Isolated displaced type II partial articular radial head fracture: correlation of preoperative imaging with intraoperative findings of lateral ulnar collateral ligament tear 《单独的移位性II型部分关节的桡骨头骨折:术前影像和术中发现外侧尺侧副韧带撕裂之间的关系》 Luigi Tarallo, Giuseppe Porcellini, Giovanni Merolla, Andrea Pellegrini, Andrea Giorgini, Fabio Catani p132–138 Published online: September 11, 2019 Full-Text HTML PDF Restriction in the hip internal rotation of the stride leg is associated with elbow and shoulder pain in elite young baseball players 《优秀青年棒球运动员腿跨步髋关节内旋受限和肩肘关节疼痛相关》 Takuya Sekiguchi, Yoshihiro Hagiwara, Yutaka Yabe, Masahiro Tsuchiya, Nobuyuki Itaya, Shinichiro Yoshida, Toshihisa Yano, Yasuhito Sogi, Kazuaki Suzuki, Eiji Itoi p139–145 Published online: September 11, 2019 Full-Text HTML PDF Basic Science基础研究 Single Assessment Numeric Evaluation scores correlate positively with American Shoulder and Elbow Surgeons scores postoperatively in patients undergoing rotator cuff repair 《在评估肩袖损伤修复手术后患者时,简化评估量化评价评分和美国肩肘外科医生评分具有正相关性》 Julia S. Retzky, Matthew Baker, Casey V. Hannan, Uma Srikumaran p146–149 Published online: August 7, 2019 Full-Text HTML PDF Validity and internal consistency of the thoracic outlet syndrome indexfor patients with thoracic outlet syndrome 《对于胸廓出口症患者胸廓出口症评分指数的有效性和内部一致性研究》 Martti Vastamäki, Niina Ruopsa, Heidi Vastamäki, Katri Laimi, Leena Ristolainen, Mikhail Saltychev p150–156 Published online: August 29, 2019 Full-Text HTML PDF Supplemental Materials A prospective study comparing tendon-to-bone interface healing using an interposition bioresorbable scaffold with a vented anchor for primary rotator cuff repair in sheep 《在羊身上进行的使用一个间置性的生物可再吸收支架及带孔锚钉修复初次肩袖撕裂的前瞻性研究以比较腱骨界面愈合情况》 Jeremiah Easley, Christian Puttlitz, Eileen Hackett, Cecily Broomfield, Lucas Nakamura, Michael Hawes, Charles Getz, Mark Frankle, Patrick St. Pierre, Robert Tashjian, P. Dean Cummings, Joseph Abboud, Derek Harper, Kirk McGilvray p157–166 Published online: August 7, 2019 Open Access Full-Text HTML PDF Density distribution of the type E2 glenoid in cuff tear arthropathy 《肩袖关节病E2型肩胛盂的骨量分布情况》 Matthew D. Mahaffy, Nikolas K. Knowles, Carolyn Berkmortel, Sejla Abdic, Gilles Walch, James A. Johnson, George S. Athwal p167–174 Published online: August 28, 2019 Full-Text HTML PDF Posterior shoulder tightness can be a risk factor of scapular malposition: a cadaveric biomechanical study 《肩关节后侧紧可能是肩胛骨位置不亮的一个风险因素:一个在尸体上的生物力学研究》 Teruhisa Mihata, Michelle H. McGarry, Masaki Akeda, Alexander B. Peterson, Ross C. Hunter, Lauren Nguyen, Masashi Neo, Thay Q. Lee p175–184 Published online: August 13, 2019 Full-Text HTML PDF Three-dimensional in vivo scapular kinematics and scapulohumeral rhythm: a comparison between active and passive motion 《体内三维肩胛骨运动学几肩胛肱骨节律:主动和被动活动的比较》 Bonggun Lee, Doosup Kim, Younghwan Jang, Hanbin Jin p185–194 Published online: August 7, 2019 Full-Text HTML PDF Relation between preoperative electromyographic activity of the deltoid and upper trapezius muscle and clinical results in patients treated with reverse shoulder arthroplasty 《反式人工肩关节置换手术患者术前三角肌和上斜方肌肌电图和术后临床疗效之间的关系》 HongRi Li, Seung-hyun Yoon, Doohyung Lee, Heewoong Chung p195–201 Published online: August 13, 2019 Full-Text HTML PDF Review Article 综述 Reverse total shoulder arthroplasty in the younger patient (≤65 years): a systematic review 65岁以下 患者的反式人工肩关节置换手术:一个系统综述 Seline Y. Vancolen, Rawaan Elsawi, Nolan S. Horner, Timothy Leroux, Bashar Alolabi, Moin Khan p202–209 Published online: September 3, 2019 Full-Text HTML PDF Supplemental Materials Online Articles在线文章 Pyrocarbon interposition shoulder arthroplasty in young arthritic patients: a prospective observational study 热解碳复合结构间置的人工肩关节置换在年轻的肩关节关节炎患者中的应用:一个前瞻性观察研究 Hugo Barret, Marc-Olivier Gauci, Tristan Langlais, Olivier van der Meijden, Laurie Tran, Pascal Boileau e1–e10 Published online: August 23, 2019 Full-Text HTML PDF Application of a new polyester patch in arthroscopic massive rotator cuff repair—a prospective cohort study 《在肩关节镜下巨大肩袖撕裂修复手术中应用一种新的聚酯纤维补片:一个前瞻群组研究》 Daniel Smolen, Nicolas Haffner, Rainer Mittermayr, Florian Hess, Christoph Sternberg, Jan Leuzinger e11–e21 Published online: August 9, 2019 Full-Text HTML PDF Mortality after inpatient stay for proximal humeral fractures 《肱骨近端骨折患者住院期间的死亡率》 John Adam, Mohannad Basil Ammori, Iliyasu Isah, Muthu Jeyam, Usman Butt e22–e28 Published online: August 26, 2019 Full-Text HTML PDF Exercise therapy may affect scapular position and motion in individuals with scapular dyskinesis: a systematic review of clinical trials 《对于肩胛骨运动功能障碍的患者运动疗法可能会影响肩胛骨的位置及运动:一个临床试验的系统综述》 Afsun Nodehi Moghadam, Leila Rahnama, Shohreh Noorizadeh Dehkordi, Shima Abdollahi e29–e36 Published online: August 13, 2019 Full-Text HTML PDF Supplemental Materials “借问肩痛去哪里,路人遥指高绪仁”。如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科高绪仁膝肩髋关节医疗组 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 关键词:美国肩肘外科杂志 肩关节 肘关节 关节镜 关节置换 高绪仁 肩关节疼痛 肩膀疼肩痛不等于肩周炎 肩周炎 冻结肩 肩关节粘连 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 反式人工肩关节及置换手术 中国 江苏 徐州 肩关节专家 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2019年11月16日周六。开卷有益!欢迎您来到《听高绪仁讲肩关节那些事儿》第166期!没有天生的专家,唯有每天坚持不懈地努力学习、实践和提升! 今天挺充实的! 国际上第一流的骨科大师都是既能做手术、又能写文章。为了更好地顺应潮流,提高肩关节SCI文章写作、投稿、修改能力,今天特地参加了2019年中国COA骨科大会国际期刊论坛活动。此次中国COA骨科大会国际期刊论坛由天津医院中国骨科杂志主编胡永成教授主办。 上午参加中国COA骨科大会国际期刊论坛,听国际骨科杂志主编及编辑谈如何写作和投稿SCI文章。 下午参加中国COA骨科大会国际期刊论坛,听国内骨科杂志主编谈如何写摘要、引言、结果和讨论及如何投稿。 傍晚,参观中国COA骨科大会人工膝关节和人工髋关节展览。 晚上,参加江苏省青年关节聚乐部江苏青年骨科医师之夜交流活动。 上图:2019年11月16日周六白天,高绪仁在中国COA骨科大会国际期刊论坛,听国际骨科杂志主编及编辑谈如何写作和投稿SCI文章;听国内骨科杂志主编谈如何写摘要、引言、结果和讨论及如何投稿。 上图:2019年11月16日周六傍晚,高绪仁参观中国COA骨科大会人工髋关节展览。 上图:2019年11月16日周六傍晚,高绪仁参观中国COA骨科大会人工膝关节展览。 上图:2019年11月16日周六傍晚,高绪仁参加江苏省青年关节聚乐部江苏青年骨科医师之夜交流活动。 今天晚上有人问我:“高主任您好!您参加中国COA骨科大会国际期刊论坛主要学到了什么?” 这是个很好的问题。 08:30-12:10 第二届国际期刊论坛 第一节 主持: Marius M. SCARLAT Clinique St Michel, Toulon, France , Francis J. HORNICEK David Geffen School of Medicine at UCLA Moderators: Marius M. SCARLAT Clinique St Michel, Toulon, France , Francis J. HORNICEK Department of orthopaedics, UCLA, LA, US 1 08:30-08:40 介绍及致辞 Introduction Speech 开幕致辞 Opening Speech 张英泽 Yingze Zhang 河北医科大学第三医院 Academician of Chinese Academy of Engineering 中华医学会骨科分会主任委员张英泽院士的发言鼓舞了我。 2 08:40-09:10 专题发言Symposium Quality and Visibility of Scientific Publications in Orthopaedics Marius M. SCARLAT Clinique St Michel, Toulon, France 欧洲International Orthopaedics杂志主编Marius M. SCARLAT 推荐今后有文章就投他们的杂志。 3 09:10-09:40 专题发言 Symposium Resident Training in Orthopaedic Surgery: UCLA Experience Francis J. HORNICEK David Geffen School of Medicine at UCLA 加州大学洛杉矶分校医学院的住院医师培训里面有一年就是教您如何做科研、如何写文章、如何申请课题。值得学习! 4 09:40-10:10 专题发言 Symposium Experimental Research Design and Methods Zhenfeng DUAN Department of Orthopaedics, UCLA, LA, US 加州大学洛杉矶分校医学院的段震峰终身教授英文非常好、发表了180多篇文章,真是厉害! 5 10:10-10:40 专题发言Symposium How to answer to reviewers comments Philippe HERNIGOU H. Mondor Hospital, Creteil, Paris, France 法国骨科学会主席、髋关节专家、国际权威的骨坏死治疗专家、法国 国家亨利蒙多医院骨科主任 Philippe Hernigou教授讲课太幽默了!把如何应对SCI论文审稿人的策略分析透了!我非常喜欢听老爷子讲课。真是一种享受!幽默的老头! 6 10:40-11:10 专题发言 Symposium The role of the Editor in on-line publication James WADDELL St Michael Hospital, Toronto, ON, Canada 进一步明白了国际骨科杂志编辑工作的流程。 7 11:10-11:40 专题发言 Symposium The Relationship of Impact Factor Citation on Quality of Papers and Journals Syed Muhammad. AWAIS President of OASAC.(2016-18) Past President Pakistan Orthopedic Association Dean, Faculty of Health Sciences, University of the Punjab. 巴基斯坦骨科学会主席对SCI杂志的分析值得我们学习。 8 11:40-12:10 专题发言Symposium Methods of review and quality of review 张卓 Zhuo Zhang 中国人民解放军总医院第一医学中心 301医院创伤骨科张卓老师年轻有为,为欧洲 International Orthopaedics杂志审阅了很多稿件。给了我很多投稿、写作的启发。 13:30-16:00 第二届国际期刊论坛 第二节 主持: 胡永成 天津医院 , 余斌 南方医科大学南方医院 Moderators: Yongcheng Hu Tianjin hospital , Bin Yu 1 13:30-14:00 专题发言 Symposium 文章前言部分的撰写 余斌 Bin Yu 南方医科大学南方医院 中华创伤骨科杂志编辑部主任 中华创伤骨科杂志编辑部主任 余斌的手下王博士重点分享了摘要和前沿的写法。分析的很透彻!谢谢! 2 14:00-14:30 专题发言Symposium 文章结果部分的撰写 孙磊 Lei Sun 解放军第八十八医院 中国矫形外科杂志主编 中国矫形外科杂志主编孙磊教授将结果的不同写法生动地展示出来,有利于我今后科学地写论文的结果部分。 3 14:30-15:00 专题发言Symposium 文章讨论部分的撰写 刘国栋 Guodong Liu 陆军特色医学中心(大坪医院)中华创伤外科杂志编辑部 中华创伤外科杂志编辑部刘国栋主任将一篇经典地文章讨论部分拿出来精细分析,给我带了很棒的收获! 4 15:00-15:30 专题发言Symposium SCI期刊投稿策略 王重芳 Zhongfang Wang Wiley Wiley高级期刊经理 王重芳老师把英文SCI文章的投稿过程分析的很透彻,给了我很多帮助。 5 15:30-16:00 专题发言Symposium 外科类期刊的办刊特点和体会 胡永成 Yongcheng Hu 天津医院 Tianjin hospital 中华骨科杂志主编 天津医院中国骨科杂志主编胡永成教授分享了办Orthopaedic Surgery的喜怒哀乐。想办一件事情办好,真的很难,但是只要坚持,就有好的可能。 “借问肩痛去哪里,路人遥指高绪仁”。如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科高绪仁膝肩髋关节医疗组 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 关键词:肩袖损伤 肩关节SCI 文章 论文 写作 投稿 高绪仁 江苏省 徐州医科大学附属医院 徐医附院 徐州二院 骨科 肩关节 关节外科 肩关节疼痛 肩膀疼 肩痛不等于肩周炎 肩周炎 冻结肩 肩关节粘连 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 反式人工肩关节及置换手术 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2019年10月17日周四 。开卷有益!欢迎您来到《听高绪仁讲肩关节那些事儿》第136期!没有天生的专家,唯有每天坚持不懈地努力学习、实践 和提升! 上图:2019年10月17日周四,高绪仁在徐州医科大学附属医院暨徐州二院骨科关节外科住院部病房指导肩袖损伤肩关节镜微创修复手术术后患者进行康复锻炼。 今天一肩袖损伤患者问我:“高主任您好!吸烟对肩袖损伤肩关节镜下微创修复手术术后腱骨愈合有影响吗?” 这个问题非常好! 随着逐渐进入老龄化社会和全面运动活动的逐渐增加,肩袖损伤的患者越来越多。我们希望通过手术修复的方法以达到解剖愈合从而减轻肩袖损伤导致的肩关节疼痛 、活动受限及无力。近年来,越来越多的肩袖损伤的患者寻求肩关节镜微创手术的方法来进行肩袖损伤修复。但是,虽然手术技术在不断提高,但是肩袖修复后腱骨愈合失 败率仍然很高(20%-94%)。所以很多研究都在探索肩袖愈合失败的影响因素。目前,发现了一些影响肩袖愈合的因素,如:年龄、术前肩袖撕裂的大小、脂肪浸润的程度 、骨质疏松情况、肌腱的质量等等。很多专家还研究发现代谢性疾病和肩袖愈合不良相关。因为代谢性疾病会影响骨骼和肌腱的质量以及局部血液微循环,而这在腱骨愈合 中扮演重要角色。有几种代谢性疾病,如糖尿病、高血脂等,和肩袖愈合失败有关。 吸烟是影响代谢的重要因素之一。吸烟释放毒性物质:尼古丁、一氧化碳。尼古丁、一氧化碳可能会通过其血管收缩作用影响肩袖愈合。 那么在临床实践中,吸烟到底会不会影响肩袖愈合呢? 韩国建国大学医学院肩关节专家Seok Won Chung等在2018年的The American Journal of Sports Medicine(美国运动医学杂志)上撰文,报道了他们临床实践中吸 烟和肩袖愈合之间的关系。 上图:韩国建国大学医学院肩关节专家Seok Won Chung等在2018年的The American Journal of Sports Medicine(美国运动医学杂志)上撰文,报道了他们临床实 践中吸烟和肩袖愈合之间的关系。 上图:吸烟组和不吸烟组患者的基本情况。 上图:吸烟组和不吸烟组患者肩袖损伤修复手术后肩袖愈合的情况。 可以看出,吸烟组的肩袖不愈合率更高。 这篇研究告诉我们什么? 这篇研究告诉我们,吸烟影响肩关节镜下肩袖损伤修复手术后和腱骨愈合率。所以,我们要注意那些吸烟的患者,特别是吸烟特别多的患者,如果他们进行肩袖损伤 修复手术,愈合失败的可能性更大。 “借问肩痛去哪里,路人遥指高绪仁”。如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后、骨科关节病方向硕士研究生导师 徐州医科大学附属医院骨科肩关节外科发展方向负责人 徐州医科大学附属医院骨科关节外科膝肩髋关节人工关节置换与关节镜手术品牌专家 参考文献: 1.Fehringer EV, Sun J, VanOeveren LS, Keller BK, Matsen FA. Fullthickness rotator cuff tear prevalence and correlation with function and co- morbidities in patients sixty-five years and older. J Shoulder Elbow Surg. 2008;17(6):881-885. 2.Back Y-W, Tae S-K, Kim M-K, Kwon O-J. The effect of different starting periods of passive exercise on the clinical outcome of arthroscopic rotator cuff repair. Clin Shoulder Elbow. 2014;17(2):57-63. 3.Meyer M, Klouche S, Rousselin B, Boru B, Bauer T, Hardy P. Does arthroscopic rotator cuff repair actually heal? Anatomic evaluation with magnetic resonance arthrography at minimum 2 years followup. J Shoulder Elbow Surg. 2012;21(4):531-536. 4.Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS. Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy. 2009;25(1):30-39. 5.Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86(2):219-224. 6.Abtahi AM, Granger EK, Tashjian RZ. Factors affecting healing after arthroscopic rotator cuff repair. World J Orthop. 2015;6(2):211-220. 7.Chung SW, Kim JY, Yoon JP, Lyu SH, Rhee SM, Oh SB. Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med. 2015;43(3):588-596. 8.Mall NA, Tanaka MJ, Choi LS, Paletta GA Jr. Factors affecting rotator cuff healing. J Bone Joint Surg Am. 2014;96(9):778-788. 9.Raman J, Walton D, MacDermid JC, Athwal GS. Predictors of outcomes after rotator cuff repair—a meta-analysis. J Hand Ther.2017;30(3):276-292. 10.Abboud JA, Kim JS. The effect of hypercholesterolemia on rotator cuff disease. Clin Orthop Relat Res. 2010;468(6):1493-1497. 11.Bedi A, Fox AJ, Harris PE, et al. Diabetes mellitus impairs tendon-bone healing after rotator cuff repair. J Shoulder Elbow Surg. 2010;19(7):978-988. 12.DeOrio J, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am.1984;66(4):563-567. 13.Mosely LH, Finseth F. Cigarette smoking: impairment of digital blood flow and wound healing in the hand. Hand. 1977;9(2):97-101. 14.Jung Ho Park; Kyung-Soo Oh; Tae Min Kim; Jayoun Kim; Jong Pil Yoon; Joon Yub Kim; Seok Won Chung.Effect of Smoking on Healing Failure After Rotator Cuff Repair.The American Journal of Sports Medicine ( IF 6.093 ) Pub Date : 2018-08-21 , DOI: 10.1177/0363546518789691 关键词: 肩关节 肩袖损伤 吸烟愈合高绪仁 江苏省 徐州医科大学附属医院 徐医附院 徐州二院 骨科 关节外科 肩关 节疼痛 肩周炎 冻结肩 肩关节粘连 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2019年3月13日周三 。开卷有益!欢迎您来到《听高绪仁讲肩关节 那些事儿》第104期!没有天生的专家,唯有每天坚持不懈地努力学习、实践和提升! 今天早上我在医院早查房。一位宿迁的肩关节手术后肩关节感染的患者来找我会诊。 上图:2019年3月13日星期三,高绪仁在徐州医科大学附属医院暨徐州二院骨科膝肩髋关节 住院部为外地肩关节手术后感染的患者进行检查评估。 今天有人问我:“高主任,今天是2019年AAOS美国骨科医师年会的第2天。今天美国的骨科 医生关于肩关节讨论了哪些方面的问题?有没有肩关节感染方面的讨论呢” 这是个非常好的问题! 今天美国骨科医师年会肩关节专场第4个专题就是关于肩关节感染的处理策略。 2019年3月12日周二至3月16日周六,2019AAOS美国骨科医师年会在美国内华达州的拉斯维 加斯举办。美国骨科医师年会上讨论的话题是世界骨科医师所关注的焦点。 2019年3月13日周三是2019年AAOS美国骨科医师年会的第2天。 关于肩关节今天主要讨论了哪些方面的问题呢? 第一个肩关节专题模块: 早上8:00-10:00 4305会议室 主题:Arthroscopic Rotator Cuff Repair:A General Instructional Course Lecture 肩关节镜下肩袖损伤修复:教程 主持人: Michael T. Freehill, MD, Ann Arbor, MI Grant E. Garrigues, MD, Durham, NC Albert Lin, MD, Pittsburgh, PA Umasuthan Srikumaran, MD, MBA, Ellicott City, MD 这一专题模块主要讲述肩关节镜下肩袖损伤修复的原则。重点强调:1、原理;2、不同的 缝合方法;3、不同的技术;4、各种工具。 第二个肩关节专题模块: 早上 11:00-12:30 3201会议室 主题:Pain Management after Shoulder Surgery – What Works? 肩关节手术后疼痛管理:什么起作用? 主持人: William N. Levine, MD, New York, NY Anthony R. Brown, MBCHB, Mamaroneck, NY Anand M. Murthi, MD, Baltimore, MD Surena Namdari, MD, MSc, Philadelphia, PA 这一专题模块主要分享和讨论肩关节手术后的疼痛控制,回顾局部神经阻滞、术中软组织 渗透、镇痛药物的使用方法及他们的疗效。 第三个肩关节专题模块: 早上 11:00-12:30 3105会议室 主题:When You’re Running Out of Room: Managing Humeral and Glenoid Bone Loss in Shoulder Arthroplasty 人工肩关节置换如何处理肱骨侧和肩胛盂侧的骨缺损 主持人: Thomas R. Duquin, MD, Buffalo, NY George S. Athwal, MD, London, ON, Canada John W. Sperling, MD, MBA, Rochester, MN Thomas (Quin) W. Throckmorton, MD, Germantown, TN 这一专题模块主要分享和讨论在进行初次人工肩关节置换手术和翻修手术时如何理解和治 疗肩胛盂侧的骨缺损和肱骨侧的骨缺损。 第四个肩关节专题模块: 下午 1:30-3:30 4305会议室 主题:I’ve Got a Culture Positive for P.Acnes—What Do I Do Now? The Diagnosis and Management of Periprosthetic Shoulder Infections 我培养发现痤疮丙酸杆菌阳性---我现在要怎么做?人工肩关节假体周围感染的诊 断和治疗 主持人: Grant E. Garrigues, MD, Chicago, IL Jason Hsu, MD, Seattle, WA Eric T. Ricchetti, MD, Cleveland, OH John W. Sperling, MD, MBA, Rochester, MN 这一专题模块主要分享和讨论人工肩关节假体周围感染的诊断和治疗。重点讨论痤疮丙酸 杆菌。本模块通过实战病例进行交互式、一步一步地进行重建手术。 第五个肩关节专题模块: 下午 4:00-6:00 2401会议室 主题:From A to P: Technical Pearls to Master Shoulder Instability Surgery! 从前到后:掌握肩关节不稳手术的技术要点! 主持人: William N. Levine, MD, New York, NY George Athwal, MD, London, ON, Canada 这一专题模块主要分享和讨论肩关节不稳手术的关节镜手术和切开手术的技术要点和要领 。 第六个肩关节专题模块: 下午 4:00-6:00 4101会议室 主题:The Failed Reverse Shoulder Arthroplasty: Step-by-Step Approach to Revision;How the Experts Think: A Case-Based Instructional Course Lecture 反式肩关节置换手术失败:步步为营进行翻修;专家是怎么想的?基于病例的互动式教程 主持人: Joseph A. Abboud, MD, Philadelphia, PA Pascal Boileau, MD, Nice, France Bassem T. Elhassan, MD, Rochester, MN Mark A. Frankle, MD, Temple Terrace, FL Laurent Lafosse, MD, Annecy, France Mark D. Lazarus, MD, Philadelphia, PA Jonathan Levy, MD, Fort Lauderdale, FL Anand M. Murthi, MD, Baltimore, MD Howard D. Routman, DO, Palm Beach Gardens, FL Joaquin Sanchez-Sotelo, MD, Rochester, MN Gerald R. Williams, MD, Philadelphia, PA 这一专题模块主要通过病例分享使得参加者世界一流肩关节专家在翻修反式人工肩关节置 换手术时如何一步一步思考及进行手术的。 第七个肩关节专题模块: 早上8:00-10:00 肩肘 肩关节肩袖损伤壁报演讲第2部分 主持人: Ian R. Byram, MD, Franklin, TN Joshua A. Baumfield, MD, Newburyport, MA 8:00 壁报号码 271 题目:The Impact of Workmans’ Compensation on Recovery after Biceps Tenodesis Eric R. Wagner, MD, Atlanta, GA 工伤赔付对肱二头肌长头腱腱固定后恢复的影响 核心要点:分析单独的肱二头肌长头腱肌腱固定患者的康复情况。工伤赔付患者在随访的 主要时间节点上疼痛感都较对照组更明显。 8:06 壁报号码 272 题目:No Difference in Clinical Outcomes Between Supra-Pectoral Arthroscopic Biceps Tenodesis and Lateral Row Biceps Tenodesis During Simultaneous Rotator Cuff Repair Jonathan C. Levy, MD, Fort Lauderdale, FL 肩袖损伤修复时关节镜下胸大肌上肱二头肌长头腱固定和外排肱二头肌长头腱固定没有临 床差异 核心要点:对于肩袖损伤修复和肱二头肌长头腱固定同时进行的患者,肩关节镜下胸大肌 上腱固定和外排肱二头肌长头腱固定两种方法的疗效相当。。 8:12 壁报号码 273 题目:An Algorithm for Managing Long Head of Biceps Pathology During Rotator Cuff Repair Anthony Maher, Auckland, New Zealand 肩袖损伤修复手术时处理肱二头肌长头腱病变的流程图 核心要点:通过大量肩袖损伤修复手术时对肱二头肌长头腱的观察,提出了手术处理肱二 头肌长头腱病损的手术流程图。 8:24 壁报号码 274 题目:Coracoid Morphology is Not Associated with Subscapularis Tears Viktor C. Tollemar, BS, Highland Park, IL 喙突形态和肩胛下肌撕裂没有关系 核心要点:研究发现喙突形态和肩胛下肌撕裂之间没有关联性。 8:30 壁报号码 275 题目:Subscapularis Tears on MRI: Are Radiologists and Orthopaedic Surgeons Seeing the Same Thing? John G. Horneff, MD, Philadelphia, PA 肩胛下肌肌腱撕裂的磁共振影像:影像科医生和骨科医生在看同一东西么? 核心要点:肩胛下肌肌腱的撕裂在磁共振上很难明确。但是骨科医生经常更加能够熟练地 明确这些撕裂。所以骨科医生不应该只是依赖于影像科医生的读片结果。 8:36 壁报号码 276 题目:Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears Hyung B. Park, MD, Changwon, Republic of Korea 非创伤性后上方肩袖撕裂的相关因素 核心要点:非创伤性后上方肩袖撕裂的相关因素。 8:48 壁报号码 277 题目:Prediction of the Irreparability of Rotator Cuff Tears In-Bo Kim, MD, Busan, Republic of Korea 预测肩袖撕裂是否不可修复 核心要点:肩袖不可修复受以下因素影响:慢性假性瘫痪、撕裂大小、肩峰肱骨之间的距 离、切线征、冈上肌肌腱脂肪浸润和受累肌腱的数量等。 8:54 壁报号码 278 题目:The Learning Curve of Superior Capsule Reconstructions Jarret M. Woodmass, MD, Calgary, AB, Canada 上关节囊重建手术的学习曲线 核心要点:上关节囊重建治疗大到巨大肩袖撕裂具有高的疼痛持续发生率,并且功能恢复 有限。患者临床失败率65%(n=22/34名患者)。 9:00 壁报号码 279 题目:Superior Capsular Reconstruction: Radiographic and Clinical Outcomes at Mean One-Year Follow Up Abigail L. Campbell, MD, New York, NY 上关节囊重建:术后随访1年的影像学和临床结果 核心要点:20名患者进行了上关节囊重建手术术后随访一年结果发现临床疗效和影像学 参数都有进步。 9:12 壁报号码 280 题目:Arthroscopic Repair of Isolated Subscapularis Tear: Single-Row Versus Double-Row Suture-Bridge Technique Yong-Min Chun, MD, PhD, Seoul, Republic of Korea 肩关节镜下修复单独的肩胛下肌肌腱撕裂:单排修复和双排修复的比较 核心要点:如果撕裂的肩胛下肌肌腱质量还好,肩关节镜下单排修复和缝线桥技术修复都 可以获得满意的临床效果,没有明显的差别。 9:18 壁报号码 281 题目:Arthroscopic Repair of Isolated Subscapularis Tears: Clinical Outcome and Structural Integrity with a Minimum Follow Up of 4.6 Years Anita Hasler, Zürich, Switzerland 肩关节镜下修复单独的肩胛下肌肌腱撕裂:最少随访4.6年的临床疗效和结构完整 性 核心要点:肩关节镜下修复单独的肩胛下肌肌腱撕裂可以获得优良的临床效果,并且中期 随访可见高愈合率。 9:24 壁报号码 282 题目:Subacromial Spacer as a Biomechanical Augmentation for Partial Repair of Rotator Cuff Tear: Clinical and Radiological Outcomes Paolo Paladini, MD, Cattolica, Italy 肩峰下间隔器作为一种生物力学加强结构来治疗肩袖部分撕裂:临床和影像学结果 核心要点:报道了采用肩峰下间隔器作为一种生物力学加强结构来治疗肩袖部分撕裂的临 床和影像学结果。 9:36 壁报号码 283 题目:Corticosteroid Injections within Three Months of Rotator Cuff Repair are Associated with Increased Revision Surgery at Two Years William W. Schairer, MD, New York, NY 肩袖损伤修复手术前3个月内进行糖皮质激素注射和术后两年增加手术翻修具有相关 性 核心要点:本研究显示肩袖损伤修复手术前3个月之内进行过糖皮质激素的患者在肩袖损伤 修复术后2年会增加失败的风险。 9:42 壁报号码 284 题目:Effect of Biceps Tenodesis on Speed of Recovery After Arthroscopic Rotator Cuff Repair Jonathan C. Levy, MD, Fort Lauderdale, FL 肱二头肌长头腱腱固定术对肩关节镜下肩袖修复手术后康复速度的影响 核心要点:肱二头肌长头腱腱固定并不影响肩袖损伤修复康复的速度。但是,没有肱二头 肌长头腱腱固定手术的患者疼痛和运动康复阶段平台更早。 9:48 壁报号码 285 题目:Prospective Sensor Controlled Compliance Analysis of the Shoulder Abduction Brace after Rotator Cuff Repair Florian Grubhofer, Zurich, Switzerland 肩袖损伤修复手术后肩关节外展支具前瞻感觉控制依从性分析 核心要点:肩袖损伤修复后经常使用外展支具。本研究显示佩戴支具依从性仅仅达到了 要求佩戴时间的50%。 第八个肩关节专题模块: 早上8:00-10:00 肩肘 肩关节肩袖损伤壁报演讲第2部分 主持人: Andrew Jawa, MD, Cambridge, MA and Julie Y. Bishop, MD, Columbus, OH 8:00 壁报号码 310 题目:Delayed Hospital Discharge after Total Shoulder Arthroplasty: Why,and Who is at Risk? Mariano Menendez, MD, Boston, MA 人工肩关节置换手术后出院时间延长:为什么及谁是风险因素? 核心要点:社会经济背景及心理因素比患者的虚弱、技术等因素更会导致术后住院时间延 长。 8:06 壁报号码 272 题目:Can Hospital Satisfaction Predict Functional Outcome after Total Shoulder Arthroplasty? Aaron M. Chamberlain, MD, St. Louis, MO 住院满意度能预测人工肩关节置换手术后的临床效果么? 核心要点:HCAHPS评分,即测定住院满意度及医保给付参考指标的一个评分,显示和人工 肩关节置换手术术后一年的功能疗效之间没有相关性。 11:12 壁报号码 312 题目:Time-Driven Activity-Based Costing to Identify High-Cost Total Shoulder Arthroplasty Patients Mariano Menendez, MD, Boston, MA 核心要点:购买人工肩关节假体的费用是人工肩关节置换手术一个主要的花费。但是努力 减少住院时间可以有效地减少患者和患者之间的费用差别。 11:24 壁报号码 313 题目:An Analysis of Costs Associated with Shoulder Arthroplasty Peter N. Chalmers, MD, Salt Lake City, UT 分析人工肩关节置换手术相关的花费 核心要点:分析人工肩关节置换手术直接的费用显示手术占了大部分的费用。并且费用和 患者的年龄、反肩的使用、肩关节骨关节炎之外的诊断等因素有关。 11:30 壁报号码 314 题目:Shoulder Arthroplasty in Patients with Upper Extremity Lymphedema May Result in Transient or Permanent Lymphedema Worsening Julia Lee, MD, Clovis, CA 具有上肢淋巴水肿的患者进行人工肩关节置换手术后可能会出现一过性的或永久性 的淋巴水肿加重 核心要点:上肢具有淋巴水肿的肩关节置换手术患者术后可能会改善疼痛及运动。但是要 慎重考虑手术,因为具有潜在的感染风险和加重淋巴水肿的可能。 11:36 壁报号码 315 题目:Osteoporosis is an Independent Risk Factor for Implant-Related Complications Following Anatomic and Reverse Total Shoulder Arthroplasty Jourdan M. Cancienne, MD, Charlottesville, VA 骨质疏松是解剖型人工肩关节置换和反式人工肩关节置换手术假体相关并发症的一 个独立风险因素 核心要点:骨质疏松是人工肩关节置换手术假体周围骨折、人工肩关节翻修的一个显著的 、独立的风险因素。这是一个术后两年的研究。该风险因素和假体类型无关。 11:48 壁报号码 316 题目:A Higher Altitude is an Independent Risk Factor for Venous Thromboembolisms following Total Shoulder Arthroplasty Dhanur Damodar, MD, Miami, FL 更高的海拔高度是人工肩关节置换手术后肺栓塞发生的一个独立风险因素 核心要点:研究医保患者数据显示海拔高度超过4000英尺是人工肩关节置换术后发生肺栓 塞的一个显著的独立因素。 11:54 壁报号码 317 题目:Opioid-Free Shoulder Arthroplasty: A Reality with Multimodal Pain Management Kiran Chatha, MD, Miami, FL 不适用阿片类药物的人工肩关节置换手术:实现多模式镇痛 核心要点:通过进行患者教育及多模式疼痛管理,可以在人工肩关节置换手术时不使用阿 片类药物,并且没有影响到患者报告的临床疗效或满意度。 12:00 壁报号码 318 题目:Pulmonary Comorbidities are Associated with Increased Major Complication Rates Following Indwelling Interscalene Nerve Catheters for Shoulder Arthroplasty Tyler J. Brolin, MD, Collierville, TN 肺部并发症和人工肩关节置换手术肌间沟臂丛神经阻滞置管增加重大并发症相关 核心要点:肺部并发症和人工肩关节置换手术肌间沟臂丛神经阻滞置管增加重大并发症 相关。这些患者可能需要调整疼痛处理策略。 第九个肩关节专题模块 主题:J Korean Perspective of Arthroscopic Surgery 韩国肩关节镜手术观点 主持人:Yong-Girl Rhee, MD, Seoul, Republic of Korea and Anthony A. Romeo, MD, Chicago, IL 本专题是美国AAOS和2019年邀请国韩国之间合办的一个专题研讨会。 I. How to Enhance Rotator Cuff Healing? Basic and Clinical Research/Treatment of Stiff Elbow: Arthroscopic and Open Treatment In-Ho Jeon, MD, PhD, Seoul, Republic of Korea 如何提高肩袖愈合率?基础和临床研究治疗肘关节僵硬:关节镜和切开手术 II. How to Handle the Complex Rotator Cuff Tear? Yang-Soo Kim, MD, Seoul, Republic of Korea 如何处理复杂的肩袖损伤? III. The Clinical Result of Arthroscopic Bone Grafting and Percutaneous K-Wires Fixation for Management of Scaphoid Nonunions Young Keun Lee, PhD, Jeonju, Republic of Korea 如何处理舟骨不愈合? IV. How to Enhance Rotator Cuff Healing? Basic and Clinical Research Joo Han Oh, Seoul, Republic of Korea 如何初进肩袖愈合?基础和临床研究 V. Arthroscopic Stabilization Procedures in Patients with a Critical Glenoid Bone Loss Sang-Jin Shin, MD, Seoul, Republic of Korea 对于肩胛盂骨缺损的患者如何进行肩关节镜下肩关节稳定手术? “借问肩痛去哪里,路人遥指高绪仁”。如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后 徐州医科大学附属医院骨科肩关节外科方向负责人 徐州医科大学附属医院骨科关节外科膝肩髋关节手术品牌专家 关键词: 肩关节 美国 AAOS 肩关节脱位 肩膀疼痛 原因 江苏省 徐州医科大学附属医院 徐医附院 徐州二院 骨科 关节外科 高绪仁 肩关节疼痛 肩周炎 冻结肩 肩关节粘连 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 听高绪仁讲肩关节那些事儿
朋友们大家好!今天是2019年3月12日周二 。开卷有益!欢迎您来到《听高绪仁讲肩关节那些事儿》第103期!没有天生的专家,唯有每天坚持不懈地努力学习、实 践和提升! 今天是我的膝肩髋关节专家门诊时间。 上图:2019年3月12日星期二,高绪仁在徐州医科大学附属医院暨徐州二院骨科膝肩髋关节专家门诊为肩关节疼痛患者进行规范化体格检查。 今天有人问我:“高主任,今天是2019年AAOS美国骨科医师年会的第一天。今天美国的骨科医生关于肩关节讨论了哪些方面的问题?” 这是个非常好的问题! 2019年3月12日周二至3月16日周六,2019AAOS美国骨科医师年会在美国内华达州的拉斯维加斯举办。美国骨科医师年会上讨论的话题是世界骨科医师所关注的焦点 。 2019年3月12日周二是2019年AAOS美国骨科医师年会的第一天。 关于肩关节今天主要讨论了哪些方面的问题呢? 第一个肩关节专题模块: 早上8:00-10:00 4301会议室 主题:Biologics in Rotator Cuff Repair: Magic or Mischief? 肩袖修复中的生物制剂:具有神奇的魔力还是恶作剧? 主持人: John M. Tokish, MD, Scottsdale, AZ Jeffrey S. Abrams, MD, Princeton, NJ Jason L. Dragoo, MD, Redwood City, CA 这一专题模块主要分享和讨论在肩关节肩袖损伤修复中使用生物制剂的情况及其对患者临床疗效的讨论。 第二个肩关节专题模块: 早上8:00-10:00 4105会议室 主题:Revision Shoulder Arthroplasty: A Step-by-Step Approach 人工肩关节置换翻修手术:一步一步进行的方法 主持人:Michael S. Khazzam, MD, Southlake, TX John M. Itamura, MD, Los Angeles, CA James D. Kelly, MD, San Francisco, CA Tom R. Norris, MD, San Francisco, CA 这一模块课程的主题就是帮助医生理解在进行人工肩关节置换翻修手术时可能遇到的各种技术难点。课程展示如何进行术前评估、如何进行术前计划、如何进行手 术入路、如何进行肱骨侧假体取出和肩胛盂假体取出、如何成功进行骨重建及如何进行假体的再植入。这个课程包括了解剖型人工肩关节置换的翻修手术和反式人工肩关节 置换手术的翻修手术。 第三个肩关节专题模块: 早上8:00-10:00 4305会议室 主题:Demystifying Winging of the Scapula and Scapulothoracic Dysfunction 揭秘翼状肩胛和肩胛胸壁关节功能障碍 主持人: Bassem T. Elhassan, MD, Rochester, MN George S. Athwal, MD, London, ON, Canada W. Benjamin Kibler, MD, Lexington, KY Peter J. Millett, MD, MSc, Vail, CO 这一专题模块给参加者提供对肩胛胸壁关节(肩胛胸壁关节功能障碍、弹响肩胛综合征、翼状肩胛)评估和处理的最新理念和方法。 第四个肩关节专题模块: 早上10:30-12:30 4103会议室 主题:Complex Shoulder Arthroplasty: Primary and Revision Anatomic and Reverse, Three-Dimensional Planning –When and How? 复杂的人工肩关节置换手术:解剖型人工肩关节置换手术和反肩置换手术的初次和翻修、三维评估:时机和怎么办? 主持人: Asheesh Bedi, MD, Ann Arbor, MI David M. Dines, MD, Uniondale, NY Joshua S. Dines, MD, New York, NY Michael T. Freehill, MD, Ann Arbor, MI Evan S. Lederman, MD, Phoenix, AZ Xinning Li, MD, Weston, MA Bradford O. Parsons, MD, New York, NY Anthony A. Romeo, MD, Chicago, IL John M. Tokish, MD, Scottsdale, AZ Gilles Walch, MD, Lyon, France Jon J. Warner, MD, Boston, MA 本专题通过典型病例展开讨论,全面理解人工肩关节置换手术。评估术前各种不同的畸形情况、肩胛盂情况、肱骨侧骨丢失的情况及之前手术失败的情况等。讨 论诊疗流程、影像学、术前模板考量、假体选择及手术技术。由人工肩关节置换领域意见领袖进行综述和讨论。 第五个肩关节专题模块: 下午1:30-3:30 3504会议室 主题:The Changing Face of Shoulder Arthroplasty: An Outpatient Procedure whose Time has Come 人工肩关节置换手术的变化:日间门诊手术时代的来临 主持人: Jonathan P. Braman, MD, Minneapolis, MN Alicia K. Harrison, MD, Minneapolis, MN Daniel Shumate, Germantown, TN Thomas (Quin) W. Throckmorton, MD, Germantown, TN 现在在美国越来越多的人工膝关节置换手术和人工髋关节置换手术成为了门诊日间手术。肩关节人工肩关节置换手术不影响行走,所以越来越多的研究认为人工肩 关节置换手术也可以称为日间门诊手术。本专题教程集中讨论门诊日间人工肩关节置换手术的优点和缺点,为患者选择提供指南,提供3种不同模式的经验。 第六个肩关节专题模块: 下午4:00-6:00 2401会议室 主题:Examination of the Shoulder for Beginners and Experts 主持人: Edward G. McFarland, MD, Lutherville, MD W. Benjamin Kibler, MD, Lexington, KY George A. Murrell, MD, Kogarah, Australia 本专题教程为骨科初级医师及高年资医师提供肩关节体格检查领域最新的进展。 第七个肩关节专题模块: 下午4:00-6:00 2201会议室 主题:Massive, Irreparable Rotator Cuff Tears: What are Our Treatment Options? 巨大的、不可修复的肩袖撕裂:我们的治疗策略是什么? 主持人: Joshua S. Dines, MD, New York, NY Asheesh Bedi, MD, Ann Arbor, MI Pascal Boileau, MD, Nice, France Bassem T. Elhassan, MD, Rochester, MN 本专题教程讨论用补片加强部分修复、肌腱转位、上关节囊重建、反式人工肩关节置换手术等方法用于治疗不可修复的肩袖撕裂的手术技术。 第八个肩关节专题模块: 早上8:00-10:00 运动医学 肩关节部分壁报演讲第1部分 主持人: Carl D. Allred, MD, Tucson, AZ Cassandra A. Lee, MD, Sacramento, CA 8:00 壁报号码 031 题目:Clinical Outcomes Following Anterior Shoulder Stabilization in Overhead Athletes: An Analysis of the MOON Instability Cohort Thai Q. Trinh, MD, Blacklick, OH 过头运动员前向肩关节不稳稳定手术后的临床疗效:分析MOON不稳人群 核心要点:肩关节镜下前下方肩关节稳定手术对于过头运动员来说具有低复发率和中度的返回过头运动项目的特点。 8:06 壁报号码 032 题目:Comparable Clinical Outcomes between Knotless and Knot-Tying Anchors for Arthroscopic Repair of Recurrent Anterior Glenohumeral Instability at Mean 4.8 Year Follow Up Isabella T. Wu, BA, Rochester, MN 关节镜下修复复发性肩关节前向盂肱关节不稳平均随访4.8年,无结锚钉和打结锚钉固定的疗效类似。 核心要点:对于肩关节镜下修复复发性肩关节前向盂肱关节不稳平均随访4.8年,发现无结锚钉和打结锚钉固定的疗效类似。 8:12 壁报号码 033 题目:Revision Shoulder Stabilization in Collision Athletes: Risk Factors and Deterioration of Intra-Articular Findings Connor Montgomery, Dublin, Ireland 碰撞对抗性运动员的肩关节稳定翻修手术:风险因素和关节内的退变性发现 核心要点:在初次手术和翻修手术时发现关节内结构有明显的退变性改变。对于年轻的运动员来说这是一个需要重视的问题。 8:24 壁报号码 034 题目:Does Medicaid Expansion Improve Access to Care for the First Time Shoulder Dislocator? Amit Momaya, MD, Birmingham, AL 医保的增加是否提高了肩关节初次脱位就医的情况? 核心要点:研究个人医保的改变对肩关节初次脱位就医状况的影响情况。 8:30 壁报号码 035 题目:Opioid Use is Reduced in Patients Treated with NSAIDS After Arthroscopic Shoulder Instability Repair: A Randomized Study Kirk A. Campbell, MD, New York, NY 肩关节镜下肩关节不稳修复手术后采用非甾体消炎镇痛药减少了鸦片类药物的使用:一个随机研究 核心要点:这个研究评估了患者的肩关节疼痛程度及羟考酮和非甾体消炎药的应用情况。 8:36 壁报号码 036 题目:Prevalence of Clinical Depression Among Patients After Shoulder Stabilization Repair: A Prospective Study Danielle G. Weekes, MD, Egg Harbor Township, NJ 肩关节稳定性修复手术后患者出现临床抑郁的发生率:一个前瞻性研究 核心要点:本研究来确认进行过初次肩关节镜下肩关节不稳手术患者的发生抑郁的发生率及其对临床疗效的影响。 8:48 壁报号码 037 题目:Return to Sport Following Coracoid Bone Block Transfer for Shoulder Instability: A Systematic Review Ibrahim M. Nadeem, Hamilton, ON, Canada 肩关节不稳采用喙突骨块转移手术后重返运动:一个系统评价 核心要点:本系统评价总结了肩关节不稳采用喙突骨块转移手术后重返运动的情况。 8:54 壁报号码 038 题目:Return to Sport after Distal Tibial Allograft Glenoid Reconstruction for Recurrent Anterior Shoulder Instability Joseph Liu, MD, Chicago, IL 同种异体腓骨远端移植重建肩胛盂来治疗复发性肩关节前向不稳后重返运动 核心要点:同种异体腓骨远端移植重建肩胛盂前侧来治疗复发性肩关节前向不稳术后5年具有总体比较高的重返运动率。但是投掷运动员和对抗性运动员之间不一致。 9:00 壁报号码 039 题目:Modified Latarjet Procedure without Capsulolabral Repair for the Treatment of Failed Previous Operative Stabilizations in Athletes Maximiliano Ranalletta, MD, Buenos Aires, Argentina 采用不修复关节囊盂唇的改良Latarjet手术治疗之前肩关节稳定手术失败的运动员 核心要点:对于进行过肩关节稳定性手术失败的运动员,采用不修复关节囊盂唇的改良Latarjet手术进行翻修获得优秀的治疗效果。大多数的患者重返运动。 9:12 壁报号码 040 题目:Posterior Glenoid Lesions on Magnetic Resonance Imaging in Adolescent Baseball Players Hyung-Lae Cho, MD, Busan, Republic of Korea 青少年棒球运动员后肩胛盂损伤的磁共振影像 核心要点:青少年棒球运动员可能会出现内撞击导致的后侧肩胛盂损伤,后侧肩胛盂变平、骨膜变厚。它的位置和Bennett损伤的位置不同。 9:18 壁报号码 041 题目:Superior Labrum Injuries in Elite Gymnasts: Symptom, Pathology, and Outcome after Surgical Repair Yasutaka Takeuchi, Funabashi, Japan 精英体操运动员上盂唇损伤:症状、病理几手术修复的临床效果 核心要点:对于精英体操运动员来说,上盂唇损伤是一种常见的病理情况。主要症状是不稳及绞锁感。进行肩关节镜下修复及理疗可以提供较好地临床疗效。 9:24 壁报号码 042 题目:Immediate Changes and Time-Based Recovery of Shoulder ROM and the Quality of Supraspinatus Muscle-Tendon and Long Head Biceps Tendon after Pitching in Youth Baseball Players: How Long is the Rest Needed? Jihyun Yeo, Goyang, Republic of Korea 核心要点:投棒球对肩关节有影响。这种影响在投棒球后72小时会康复。所以,建议投棒球后休息3天,以避免损伤。 9:36 壁报号码 043 题目:Novel Subpectoral Biceps Tenodesis Technique: A Biomechanical and Clinical Analysis Thomas K. Stoops, MD, Riverview, FL 介绍一种新的胸大肌下肱二头肌长头腱固定技术:生物力学及临床分析 核心要点:这种新的胸大肌下肱二头肌长头腱固定技术在生物力学上显示出胜过单皮质带袢钢板的固定方式,和界面螺钉的固定相当。并且具有较好的临床效果。 9:42 壁报号码 044 题目:Outcomes and Return to Sport After Pectoralis Major Tendon Repair: A Systematic Review James Yu, Hamilton, ON, Canada 胸大肌肌腱修复手术后的临床疗效及重返运动的情况:一个系统综述 核心要点:对胸大肌肌腱修复手术后的临床疗效及重返运动的情况进行了一个系统综述。 9:48 壁报号码 045 题目:Shoulder Surgery in Professional Baseball Players Peter N. Chalmers, MD, Salt Lake City, UT 职业棒球运动员的肩关节手术 核心要点:统计职业棒球运动员肩关节手术后的情况发现,总的重返运动的比例为56%,而只有41%的术后运动员能够恢复到术前的运动水准。 “借问肩痛去哪里,路人遥指高绪仁”。如果您有任何关于肩关节的问题,欢迎您登录高绪仁好大夫在线网站进行咨询!网址链接 https://gaoxurendr.haodf.com/ 谢谢! 高绪仁 副主任医师、副教授、医学博士/博士后 徐州医科大学附属医院骨科肩关节外科方向负责人 徐州医科大学附属医院骨科关节外科膝肩髋关节手术品牌专家 关键词: 肩关节 美国 AAOS 肩关节脱位 肩膀疼痛 原因 江苏省 徐州医科大学附属医院 徐医附院 徐州二院 骨科 关节外科 高绪仁 肩关节疼痛 肩周炎 冻结肩 肩关节粘连 肩袖损伤 肱二头肌长头腱 炎症 损伤 撕裂 肩关节镜微创手术 听高绪仁讲肩关节那些事儿
2013 年 11 月 7 日,高绪仁参加了 COA-AAOS 肩关节专项培训。受益匪浅,为进一步更好地为肩关节伤病患者提供更好地医疗服务打下了基础。感谢北京积水潭医院肩关节专家姜春岩主任、北医三院肩关节专家崔国庆主任的组织和美国 AAOS (美国骨科医师学会)肩关节专家 WilliamStetson 、 BuddySavoie 、 GuidoMarra 和 ScottPowell 的精彩授课!谢谢!!! AAOS ( American Academy of OrthopaedicSurgeons ,美国骨科医师学会),成立于 1933 年,是为世界上的骨科医师和其他学科医师提供骨与软组织教育的卓越组织。 高绪仁获 2013COA-AAOS 肩关节专项教育培训证书。 COA-AAOS 肩关节综合会场 2013 年11月7日 上午:肩关节骨折、关节炎及关节成形术 时间 专题 演讲人 Comments 8:00-8:10am 欢迎致辞和介绍 William Stetson 肩关节骨折:肱骨近端、锁骨及锁骨远端骨折 (主持人 William Stetson,薛庆云) 8:10-8:30am 肱骨近端骨折:非手术治疗和手术技巧(切开复位内固定/包括关节镜下治疗) Buddy Savoie 20分钟演讲 8:30-8:50am 肱骨近端骨折:如何预防并发症 Chunyan Jiang 20分钟演讲 8:50-9:00am 肱骨近端骨折:手术技巧——半肩关节置换术 vs. 反式全肩关节置换术 Guido Marra 20分钟演讲 9:00-9:20am 锁骨中段及远端骨折:非手术治疗和手术治疗 Scott Powell 20分钟演讲 9:20-10:00am 讨论和病例汇报:Drs. Marra, Powell, Savoie, Stetson, 薛庆云,王蕾 姜春岩 40分钟病例汇报及讨论 10:00-10:20am 茶歇 肩关节炎和肩关节置换术:盂肱关节和肩锁关节(主持人:Scott Powell,王蕾) 10:20-10:40am 盂肱关节炎:诊断、影像学评估和治疗 Guido Marra 20分钟演讲 10:40-11:00am 肩袖病变:诊断、影像学评估和治疗 Buddy Savoie 20分钟演讲 11:00-11:20am 肩关节翻修术:精华与糟粕 Guido Marra 20分钟演讲 11:20-12:00pm 讨论和病例汇报:Drs. Marra, Powell, Savoie, Stetson, 唐康来,王蕾 姜春岩 40分钟病例汇报及讨论 12:00-1:00pm 午餐 下午:肩关节镜——从初级到高级 肩关节镜 I:适应证、入路选择、正常解剖以及肩关节失稳定(主持人:Guido Marra,赵金忠) 1:00-1:20pm 肩关节镜介绍:适应证、体位、手术设备、入路选择、诊断性关节镜检查 William Stetson 20分钟演讲 1:20-1:40pm 多方向失稳定:非手术治疗和手术治疗 Guido Marra 20分钟演讲 1:40-2:00pm 前方失稳定:手术治疗技巧,包括骨性Bankart病变处理 Scott Powell 20分钟演讲 2:00-2:20pm 前方失稳定:关节镜下双排Bankart修复技术 崔国庆 20分钟演讲 2:20-2:40pm 伴有骨缺损的前方失稳定:关节镜技术及小切口Latarjet技术 Buddy Savoie 20分钟演讲 2:40-3:15pm 讨论和病例汇报:Drs. Marra, Powell, Savoie, Stetson,崔国庆,赵金忠,戴雪松 cuiguoqing 35分钟病例汇报及讨论 3:15-3:30pm 茶歇 肩关节镜 II:SLAP损伤和关节镜下肩袖损伤修复的高等技术(主持人:Buddy Savoie,薛庆云) 3:30-3:50pm SLAP损伤:非手术治疗和手术治疗 Scott Powell 20分钟演讲 3:50-4:10pm 撞击和部分层厚肩袖损伤:非手术治疗和手术治疗 William Stetson 20分钟演讲 4:10-4:30pm 肩袖全层损伤:关节镜下修复技术 Buddy Savoie 20分钟演讲 4:30-4:50pm 严重肩袖损伤的关节镜下处理 William Stetson 20分钟演讲 4:50-5:30pm 讨论和病例汇报:Drs. Marra, Powell, Savoie, Stetson, 陈世益,薛庆云,赵金忠 崔国庆 40分钟病例汇报及讨论 COA-AAOS Instructional Course AAOS-Chinese Orthopaedic Association (COA) Comprehensive Shoulder Program Dates 7 November 2013 Location Beijing, China Faculty Dr. William Stetson (Course Director), Dr. Guido Marra, Dr. Scott Powell, Dr. Buddy Savoie November 7 Morning Session: Shoulder Fractures, Arthritis and Arthroplasty Time Session/Topic Faculty 8:00-8:10 AM Welcome and Introductions Dr. William Stetson Shoulder Fractures: Proximal Humerus, Clavicle and Distal Clavicle Fractures (Moderators Dr. William Stetson and Dr. Qingyun Xue) 8:10-8:30 AM Proximal Humerus Fractures: Non-Operative and Operative Techniques (ORIF/including arthroscopic Tx) Dr. Buddy Savoie 8:30-8:50 AM Proximal Humerus Fractures: How to Prevent Complications Dr. Chunyan Jiang 8:50-9:00 AM Proximal Humerus Fractures: Operative Techniques-Hemiarthroplasty vs. Reverse Total Shoulder Dr. Guido Marra 9:00- 9:20 AM Mid and Distal Clavicle Fractures: Non-Operative and Operative Management Dr. Scott Powell 9:20- 10:00 AM Discussion and Case Presentation: Drs. Marra, Powell, Savoie, Stetson, Quingyun Xue, Lei Wang (Cases provided by COA Faculty) Dr. Chunyan Jiang 10:00-10:20 AM Coffee Break Shoulder Arthritis and Arthroplasty: Glenohumeral Joint and Acromioclavicular Joint (Moderators Dr. Scott Powell and Dr. Lei Wang) 10:20-10:40 AM Glenohumeral Joint Arthritis: Diagnosis, Radiographic Evaluation and Treatment Dr. Guido Marra 10:40-11:00 AM Rotator Cuff Arthroplasty: Diagnosis, Radiographic Evaluation and Treatment Dr. Buddy Savoie 11:00-11:20 AM Revision Arthroplasty: Pearls and Pitfalls Dr. Guido Marra 11:20AM-12:00PM Discussion and Case Presentations: Drs. Marra, Powell, Savoie, Stetson, Kanglai Tang, Lei Wang Dr. Chunyan Jiang 12:00-1:00 PM Lunch Afternoon Session: Shoulder Arthroscopy- Beginning to Advanced Shoulder Arthroscopy I: Indications, Portal Placement, Normal Anatomy, and Instability (Moderators Dr. Guido Marra and Dr. Jinzhong Zhao) 1:00-1:20 PM Introduction to Shoulder Arthroscopy: Indications, Positioning, Set-up, Portal Placement, Diagnostic Arthroscopy Dr. William Stetson 1:20-1:40 PM Multidirectional Instability: Non-Operative and Operative Management Dr. Guido Marra 1:40-2:00 PM Anterior Instability: Technique of Operative Management Including Bony Bankart Lesions Dr. Scott Powell 2:00-2:20 PM Anterior Instability: Arthroscopic Technique of Double Row Bankart Repair Dr. Guoqing Cui 2:20-2:40 PM Anterior Instability with Bone Loss: Arthroscopic and Mini-Open Latarjet Dr. Buddy Savoie 2:40-3:15 PM Discussion and Case Presentation: Drs. Marra, Powell, Savoie, Stetson, Guoqing Cui, Jinzhong Zhao, Xuesong Dai Dr. Guoqing Cui 3:15-3:30 PM Coffee Break Shoulder Arthroscopy II: Advanced Techniques for SLAP Lesions and Arthroscopic Rotator Cuff Repair (Dr. Buddy Savoie and Dr. Qingyun Xue) 3:30-3:50 PM SLAP Tears: Non-Operative and Operative Management Dr. Scott Powell 3:50-4:10 PM Imingement and Partial Thickness Rotator Cuff Tears: Non-Operative and Operative Management Dr. William Stetson 4:10-4:30 PM Full Thickness Rotator Cuff Tears: Arthroscopic Techniques of Repair Dr. Buddy Savoie 4:30-4:50 PM Arthroscpic Management of Massive Rotator Cuff Tears Dr. William Stetson 4:50-5:30 PM Discussion and Case Presentation: Drs. Marra, Powell, Savoie, Stetson, Shiyi Chen, Qingyun Xue, Jinzhong Zhao Dr. Guoqing Cui
2013年10月22日江苏徐州肩关节镜微创手术Journal Club预告 Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年10月22日 19:00-20:00 Time: 19:00-20:00 October 22nd 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科(徐医附院骨科、徐州二院骨科)医生办公室 Place:The orthopaedic surgeons' office ,north district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: Open Orthop J. 2013 Sep 6;7:347-51. doi: 10.2174/1874325001307010347. The painful shoulder: shoulder impingement syndrome. 肩关节疼痛:肩关节撞击综合征 Khan Y, Nagy MT, Malal J, Waseem M. Source Department of Trauma and Orthopaedic Surgery, Macclesfield District General Hospital, Victoria Road, Macclesfield, SK10 3BL, UK. Abstract Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care.肩袖损伤是初级医疗机构和二级医疗机构最常遇到的肩关节疼痛原因。 The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma as it passes under the coracoacromial arch.肩峰下撞击的病理和慢性的反复损伤有关,即肩袖联合肌在喙肩弓下方经过的时候不断反复受到挤压及微创伤。 However acute traumatic injuries may also lead to this condition.然而,急性的肩关节创伤也可能导致肩峰下撞击。 Diagnosis remains a clinical one, however advances in imaging modalities have enabled clinicians to have an increased understanding of the pathological process.诊断主要还是依靠临床体格检查,但是影像学技术的不断进步使得临床医生对这个病的病理认识逐渐加深。 Ultrasound scanning appears to be a justifiable and cost effective assessment tool following plain radiographs in the assessment of shoulder impingment, with MRI scans being reserved for more complex cases.在评价肩关节撞击综合征时,首先进行平片检查,然后就可以采用超声检查,超声检查是一种合理的、经济的检查方法。核磁共振MRI检查可用于更复杂的肩关节病例。 A period of observed conservative management including the use of NSAIDs, physiotherapy with or without the use of subacromial steroid injections is a well-established and accepted practice. 观察发现,经过一段时间的保守治疗(如服用非甾体消炎药、理疗、肩峰下封闭注射疗法等)是可以使许多患者症状减轻。However, in young patients or following any traumatic injury to the rotator cuff, surgery should be considered early.但是,对于年轻的患者或者有肩袖损伤的患者,应该考虑早期手术治疗。 If surgery is to be performed this should be done arthroscopically and in the case of complete rotator cuff rupture the tendon should be repaired where possible. 如果要进行手术治疗,应该进行肩关节镜下微创手术治疗。对于肩袖完全撕裂损伤的患者,应尽可能地修复肩袖损伤。 KEYWORDS: 关键词 Shoulder impingement syndrome,肩关节撞击综合征 arthroscopic subacromial decompression (ASAD).,肩关节镜下肩峰下减压术 rotator cuff 肩袖
2013年10月6日江苏徐州肩关节镜微创手术Journal Club预告 Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年10月6日 19:00-20:00 Time: 19:00-20:00 October 6th 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科(徐医附院骨科、徐州二院骨科)医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: Clin Orthop Surg. 2013 Sep;5(3):202-8. doi: 10.4055/cios.2013.5.3.202. Epub 2013 Aug 20. The prevalence of os acromiale in korean patients visiting shoulder clinic. 韩国肩关节门诊患者肩峰小骨的出现率 Kumar J , Park WH , Kim SH , Lee HI , Yoo JC . Source Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Abstract BACKGROUND: The prevalence of os acromiale has been documented to be between 1% and 15% and is known to be clinically associated with subacromial impingement or rotator cuff tear. However, the prevalence of os acromiale in Korea has not yet been determined. The purpose of this study is to evaluate the prevalence of os acromiale in Korean patients who visited shoulder clinics and to investigate the correlations with rotator cuff tear. METHODS: We retrospectively reviewed the X-rays of patients visiting a shoulder clinic at a tertiary hospital in Korea from January 2011 to January 2012 to determine the frequency of os acromiale. X-ray findings were confirmed with magnetic resonance imaging (MRI) for patients who had these images available. MRI was also used to assess the status of the rotator cuff . The correlation between the presence of os acromiale either with gender, hand dominance or rotator cuff tear was analyzed statistically. RESULTS: A total of 2,946 shoulders from 1,568 patients were analyzed with X-rays. Thirteen cases out of 1,568 patients had an os acromiale; and there were five and eight cases of pre-acromiale and meso-acromiale, respectively. Thus, the prevalence of os acromiale in this study population was found to be 0.7 (7 cases per 1,000 patients). Bilaterality was found in two cases. Os acromiale was not more frequent according to gender (five males versus eight females, p = 0.525) and hand dominance was not associated with frequency of os acromiale (seven dominant arms versus six non-dominant arms, p = 0.631). A sub-analysis of shoulders with available MRIs (1,074 shoulders) revealed that there were two rotator cuff tears (40%) out of five cases of os acromiale, whereas 607 rotator cuff tears were observed (57%) among 1069 cases without os acromiale. This difference was not statistically significant (p = 0.656). CONCLUSIONS: The identified prevalence of os acromiale in Korean patients who visited shoulder clinics is 0.7%, which is much lower as compared with the prevalence of general population from other ethnic groups. No correlation was observed between rotator cuff tears and os acromiale in this study population. KEYWORDS: Os acromiale, Radiography, Rotator cuff tear
2013年10月5日江苏徐州肩关节镜微创手术Journal Club预告 Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年10月5日 19:00-20:00 Time: 19:00-20:00 October 5th 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科(徐医附院骨科、徐州二院骨科)医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: Singapore Med J. 2013 Sep;54(9):524-30. Clinics in diagnostic imaging (148). Bursal-sided partial-thickness supraspinatus tendon tear. 滑膜侧冈上肌肌腱部分撕裂的临床影像诊断 Bhagwani SG , Peh WC . Source Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Alexandra Health, 90 Yishun Central, Singapore 768828. wilfred.peh@gmail.com. Abstract Rotator cuff injury comprises a continual spectrum of lesions ranging from tendinopathy, which may progress to partial- or full-thickness tear. This progression may be influenced by the interplay of extrinsic and intrinsic factors. We describe the case of a 29-year-man who presented with right shoulder pain for one year. His initial magnetic resonance (MR) arthrogram showed supraspinatus tendinopathy. Subsequent MR arthrogram, obtained after a road traffic accident, showed a bursal-sided partial-thickness tear of the supraspinatus tendon. In view of his worsening clinical symptoms, surgery was performed ten months later, revealing a full-thickness rotator cuff tear near the tendon insertion, with a tight subacromial space and bony protuberance of the humeral head. The pathogenesis of rotator cuff injuries, the roles of different imaging modalities in the diagnosis of rotator cuff injuries, as well as the advantages and limitations of various radiological modalities, are discussed.
2013年10月1日江苏徐州肩关节镜微创手术Journal Club预告 Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年10月1日 19:00-20:00 Time: 19:00-20:00 October 1st 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科(徐医附院骨科、徐州二院骨科)医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: Bull Hosp Jt Dis (2013). 2013;71(2):128-31. A laboratory comparison of a new arthroscopic transosseous rotator cuff repair to a double row transosseous equivalent rotator cuff repair using suture anchors. 一种新型的关节镜下穿骨肩袖修复方法与双排类似穿骨肩袖修复方法的实验室比较研究 Kummer FJ , Hahn M , Day M , Phil M , Meislin RJ , Jazrawi LM . Abstract Background:Because current instrumentation makes it possible to perform an arthroscopic transosseous rotator cuff repair, we performed a biomechanical comparison of a double-row transosseous equivalent rotator cuff repair using suture anchors to an arthroscopic, transosseous rotator cuff repair to determine if they provided similar fixation stability. Methods:Six pairs of shoulders were used. One of each pair had a standard double row, transosseous equivalent arthroscopic rotator cuff repair using a suture-bridge technique with suture anchors, and the other had an arthroscopic transosseous repair using an Xbox technique. The repairs were cycled at 150 N for 10,000 cycles with movement of the lateral cuff edge recorded and then tested to failure. Results:The total cuff edge displacement at 10,000 cycles in the anchor group (transosseous equivalent repair) was 7.9 mm and 6.3 mm for the bone tunnel group (transosseous repair); these were not significantly different (p = 0.19). The anchor group failed at an average of 309 N and the bone tunnel group at an average of 339 N (p = 0.22). Discussion:Biomechanical testing suggests that arthroscopic, transosseous rotator cuff repair using a Xbox suture configuration is similar in strength and stability to an arthroscopic transosseous equivalent suture-bridge repair. Both techniques demonstrated difficulty in maintaining the lateral position of the tendon. PMID:24032613 Free full text
Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年9月24日 19:00-20:00 Time: 19:00-20:00 September 24th 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: J Clin Diagn Res. 2013 Jul;7(7):1482-5. doi: 10.7860/JCDR/2013/4473.3180. Epub 2013 Jul 1. Calcific tendinitis of the rotator cuff: a review. 肩袖钙化性肌腱炎:综述 Kachewar SG , Kulkarni DS . Source Associate Professor, Department of Radio-diagnosis, Rural Medical College (RMC) , PIMS, Loni, India . Abstract Calcifying tendinitis of the rotator cuff is a common disorder; its underlying mechanism still remains unknown. Although details of the clinical presentation(s) and pathological changes which are associated with calcific tendinitis are available, conservative management of this condition remains a topic of debate. About 90% of the patients can be treated non - operatively, but as some are resistant to conservative treatment; newer techniques or surgery should be indicated. Rheumatologists and radiologists have often described this shoulder abnormality, leading to its progressive differentiation from other painful shoulder syndromes. The conservative treatment includes the use of non - steroidal anti - inflammatory agents, roentegen therapy, physical modalities for controlling the pain and for preventing loss of joint mobility, local steroid injections, and open or arthroscopic surgeries. Results of non - operative treatments have also been satisfactory. These include heat, cold, range of motion and pendulum exercises, diathermy, short - wave, and radiation therapy. Rest, immobilization with a sling, and oral non - steroidal and steroid anti - inflammatory medications have also been mentioned. This review aimed at looking at calcific tendinitis of the rotator cuff with a wide vision in the light of modern advances; while at the same time, not disregarding the past experiences. KEYWORDS: Calcific tendinitis of shoulder , Conservative management, Imaging, Plain radiograph shoulder , Rotator cuff
Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年9月20日 19:00-20:00 Time: 19:00-20:00 September 20th 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: J Clin Diagn Res. 2013 Feb;7(2):371-3. doi: 10.7860/JCDR/2013/5190.2773. Epub 2013 Feb 1. Anterior Dislocation of the Shoulder Due to an Idiopathic Deltoid Contracture-the Report of a Rare Presentation. 特发性三角肌挛缩导致的肩关节前脱位--- 一例少见病例报道 Vadapalli S . Source Professor, Department of Orthopaedics, Konaseema Institute of Medical Scienes , Amalapuram, Andhra Pradesh, India . Abstract Post injection fibrosis leading to muscle contracture is a known complication. Deltoid fibrosis is known to occur following trauma or an intramuscular injection. Idiopathic Deltoid fibrosis leading to abduction contracture and anterior dislocation of the shoulder is a rare entity. Prompt diagnosis and surgery by distal release of fibrosed Deltoid muscle will lead to good functional recovery. KEYWORDS: Abduction contracture, Deltoid fibrosis, Distal release, Shoulder dislocation
Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年9月16日 19:00-20:00 Time: 19:00-20:00 September 16th 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: Clin Orthop Surg. 2013 Jun;5(2):89-97. doi: 10.4055/cios.2013.5.2.89. Epub 2013 May 15. Current biomechanical concepts for rotator cuff repair. 肩袖损伤修复的当前生物力学观念 Lee TQ . Source Orthopaedic Biomechanics Laboratory, Long Beach VA Healthcare System, Long Beach Department of Orthopaedic Surgery, University of California, Irvine, CA 90822, USA. tqlee@med.va.gov Abstract For the past few decades, the repair of rotator cuff tears has evolved significantly with advances in arthroscopy techniques, suture anchors and instrumentation. From the biomechanical perspective, the focus in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing . To accomplish these objectives, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. In addition, the healing response may be compromised by intrinsic factors such as decreased vascularity, hypoxia, and fibrocartilaginous changes or aforementioned extrinsic compression factors. Furthermore, it is well documented that torn rotator cuff muscles have a tendency to atrophy and become subject to fatty infiltration which may affect the longevity of the repair. Despite all the aforementioned factors, initial fixation strength is an essential consideration in optimizing rotator cuff repair. Therefore, numerous biomechanical studies have focused on elucidating the strongest devices, knots, and repair configurations to improve contact characteristics for rotator cuff repair. In this review, the biomechanical concepts behind current rotator cuff repair techniques will be reviewed and discussed. KEYWORDS: Biomechanics, Load to failure, Rotator cuff repair, Transosseous-equivalent
Shoulder Arthroscopy Journal Club in Xuzhou,Jiangsu province, China 让我们一起感受肩关节镜微创手术的魅力!!! Let's enjoy the charm of shoulder arthroscopy ! 时间:2013年9月12日 19:00-20:00 Time: 19:00-20:00 September 12th 2013 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科医生办公室 Place:The orthopaedic surgeons' office ,North district ,9th floor,the newest inpatient building, the affiliated hospital of Xuzhou medical college, 99 West Huaihai road,Xuzhou,Jiangsu province,China 主讲人:高绪仁 大夫 Speaker: Dr. Xuren Gao 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 Participants:Doctors and medical students from Xuzhou and nearby cities who are interested in shoulder surgery and shoulder arthroscopy 主讲内容: Topic: Arthritis Res Ther. 2012 Jun 15;14(3):214. doi: 10.1186/ar3846. Recent advances in shoulder research. 肩关节研究的新进展 Killian ML , Cavinatto L , Galatz LM , Thomopoulos S . Source Department of Orthopaedic Surgery, Washington University, St Louis, MO 63110, USA. 美国华盛顿大学骨科 Abstract Shoulder pathology is a growing concern for the aging population, athletes, and laborers. Shoulder osteoarthritis and rotator cuff disease represent the two most common disorders of the shoulder leading to pain, disability, and degeneration. While research in cartilage regeneration has not yet been translated clinically, the field of shoulder arthroplasty has advanced to the point that joint replacement is an excellent and viable option for a number of pathologic conditions in the shoulder . Rotator cuff disease has been a significant focus of research activity in recent years, as clinicians face the challenge of poor tendon healing and irreversible changes associated with rotator cuff arthropathy. Future treatment modalities involving biologics and tissue engineering hold further promise to improve outcomes for patients suffering from shoulder pathologies.
让我们一起感受肩关节镜微创手术的魅力!!! 时间:2013年9月8日 19:00-20:00 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科医生办公室 主讲人:高绪仁 大夫 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 主讲内容: PLoS One. 2013 Jul 11;8(7):e68515. doi: 10.1371/journal.pone.0068515. Print 2013. Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis. Zhang Q , Ge H , Zhou J , Yuan C , Chen K , Cheng B . Source Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China ; First Clinical Medical College, Nanjing Medical University, Nanjing, China. Abstract BACKGROUND: The single-row and double-row fixation techniques have been widely used for rotator cuff tears. However, whether the double-row technique produces superior clinical or anatomic outcomes is still considered controversial. This study aims to use meta-analysis to compare the clinical and anatomical outcomes between the two techniques. METHODS: The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before November 1, 2012. Studies clearly reporting a comparison of the single-row and double-row techniques were selected. The Constant, ASES, and UCLA scale systems and the rotator cuff integrity rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model. RESULTS: Eight studies were included in this meta-analysis. The weighted mean differences of the ASES (-0.84; P = 0.04; I(2) = 0%) and UCLA (-0.75; P = 0.007; I(2) = 0%) scales were significantly low in the single-row group for full-thickness rotator cuff tears. For tear sizes smaller than 3 cm, no significant difference was found between the groups no matter in Constant (P = 0.95; I(2) = 0%), ASES (P = 0.77; I(2) = 0%), or UCLA (P = 0.24; I(2) = 13%) scales. For tear sizes larger than 3 cm, the ASES (-1.95; P = 0.001; I(2) = 49%) and UCLA (-1.17; P = 0.006; I(2) = 0%) scales were markedly lower in the single-row group. The integrity of the rotator cuff (0.81; P = 0.0004; I(2) = 10%) was greater and the partial thickness retear rate (1.93; P = 0.007; I(2) = 10%) was less in the double-row group. Full-thickness retears showed no difference between the groups (P = 0.15; I(2) = 0%). CONCLUSION: The meta-analysis suggests that the double-row fixation technique increases post-operative rotator cuff integrity and improves the clinical outcomes, especially for full-thickness rotator cuff tears larger than 3 cm. For tear sizes smaller than 3 cm, there was no difference in the clinical outcomes between the two techniques. LEVEL OF EVIDENCE: Level I. PMID: 23874649 PMCID: PMC3708899 Free PMC Article Images from this publication. See all images (14) Free text LinkOut - more resources PLoS One. 2013 Jul 11;8(7):e68515. doi: 10.1371/journal.pone.0068515. Print 2013. Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis. Zhang Q , Ge H , Zhou J , Yuan C , Chen K , Cheng B . Source Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China ; First Clinical Medical College, Nanjing Medical University, Nanjing, China. Abstract BACKGROUND: The single-row and double-row fixation techniques have been widely used for rotator cuff tears. However, whether the double-row technique produces superior clinical or anatomic outcomes is still considered controversial. This study aims to use meta-analysis to compare the clinical and anatomical outcomes between the two techniques. METHODS: The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before November 1, 2012. Studies clearly reporting a comparison of the single-row and double-row techniques were selected. The Constant, ASES, and UCLA scale systems and the rotator cuff integrity rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model. RESULTS: Eight studies were included in this meta-analysis. The weighted mean differences of the ASES (-0.84; P = 0.04; I(2) = 0%) and UCLA (-0.75; P = 0.007; I(2) = 0%) scales were significantly low in the single-row group for full-thickness rotator cuff tears. For tear sizes smaller than 3 cm, no significant difference was found between the groups no matter in Constant (P = 0.95; I(2) = 0%), ASES (P = 0.77; I(2) = 0%), or UCLA (P = 0.24; I(2) = 13%) scales. For tear sizes larger than 3 cm, the ASES (-1.95; P = 0.001; I(2) = 49%) and UCLA (-1.17; P = 0.006; I(2) = 0%) scales were markedly lower in the single-row group. The integrity of the rotator cuff (0.81; P = 0.0004; I(2) = 10%) was greater and the partial thickness retear rate (1.93; P = 0.007; I(2) = 10%) was less in the double-row group. Full-thickness retears showed no difference between the groups (P = 0.15; I(2) = 0%). CONCLUSION: The meta-analysis suggests that the double-row fixation technique increases post-operative rotator cuff integrity and improves the clinical outcomes, especially for full-thickness rotator cuff tears larger than 3 cm. For tear sizes smaller than 3 cm, there was no difference in the clinical outcomes between the two techniques. LEVEL OF EVIDENCE: Level I. PMID: 23874649 PMCID: PMC3708899 Free PMC Article Images from this publication. See all images (14) Free text LinkOut - more resources
让我们一起感受肩关节镜微创手术的魅力!!! 时间:2013年9月3日 19:00-20:00 地点:江苏省徐州市淮海西路99号徐州医学院附属医院新大楼九楼北区骨科医生办公室 主讲人:高绪仁 大夫 参加讨论人员:徐州及周边地区对肩关节运动损伤关节镜微创手术感兴趣的医生、医学生 主讲内容: Bull NYU Hosp Jt Dis. 2011;69(1):44-9. Anterior shoulder instability - a history of arthroscopic treatment. 肩关节前向不稳---肩关节关节镜治疗的历史 Pope EJ , Ward JP , Rokito AS . Source Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases New York, NY, USA. Abstract The glenohumeral joint is the most commonly dislocated joint in the body. The prevalence of this condition and the instability that may result from it has been a focus of diagnosis and treatment since the original description of the Bankart lesion in 1923. Now, with the introduction of MRI, lesions causing anterior shoulder instability can be diagnosed more accurately. This has led to improved understanding of the pathoanatomy that must be addressed and corrected during surgical repair. Initial attempts at arthroscopic treatment, including staple repair, transosseus suture repair, rivets, and thermal capsulorraphy were fraught with complications and unacceptably high recurrence rates. The development of arthroscopic suture anchors have revolutionized the treatment of anterior shoulder instability, such that arthroscopic management is now the standard of care. In the hands of experienced surgeons, outcomes for arthroscopic treatment of shoulder instability now approaches the success of open treatment. PMID: 21332438 Free full text
今日研学美国肩关节镜手术一流大师Burkhart, Stephen S.医生的肩关节镜名著《Burkhart's View of the Shoulder: A Cowboy's Guide to Advanced Shoulder Arthroscopy, 1st Edition》(《Burkhart肩关节镜高级手术技术》第1版)英文版第8章。受益匪浅。 8Gaining Speed and Tricks of the Trade第8章获得交易的速度和技巧 Cowboy Principle 8 Set your pace by the distance you've got to ride 江苏省徐州医学院附属医院骨科 关节镜、膝肩肘踝腕髋关节外科、骨科运动创伤方向 高绪仁 高绪仁:每天以解决膝、肩、肘、踝、腕、髋关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩、肘、踝、腕、髋关节问题,更是给其带来希望、未来和新生! 高绪仁的2013年:肩关节Style!
今日研学美国肩关节镜手术一流大师Burkhart, Stephen S.医生的肩关节镜名著《Burkhart's View of the Shoulder: A Cowboy's Guide to Advanced Shoulder Arthroscopy, 1st Edition》(《Burkhart肩关节镜高级手术技术》第1版)英文版第2章。受益匪浅。 2 Angle of Approach 第2章 肩关节镜手术入路角度 Cowboy Principle 2 Shoot straight or not at all
晚上认真研学了世界肩关节外科学第一名著英文版Rockwood and Matsen's The Shoulder: Expert Consult - Online and Print, 4e (Shoulder (Rockwood/Matsen)(2 Vol.))(《肩关节外科学(第4版))之第15章 儿童肩部骨折、脱位和先天性疾病 ,受益匪浅! 感谢Paul D. Choi, MD, Gilbert Chan, MD, David L. Skaggs, MD, and John M. Flynn, MD的精彩总结! Chapter 15 Fractures, Dislocations, and Acquired Problems of the Shoulder in Children 第15章 儿童肩部骨折、脱位和先天性疾病 FRACTURES OF THE PROXIMAL HUMERUS 肱骨近端骨折 FRACTURES OF THE CLAVICLE 锁骨骨折 FRACTURES OF THE SCAPULA 肩胛骨骨折 江苏省徐州医学院附属医院骨科 关节镜、膝肩肘踝腕髋关节外科、骨科运动创伤方向 高绪仁 高绪仁:每天以解决膝、肩、肘、踝、腕、髋关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩、肘、踝、腕、髋关节问题,更是给其带来希望、未来和新生! 高绪仁的2013年:肩关节Style!
晚上认真研学了世界肩关节外科学第一名著英文版Rockwood and Matsen's The Shoulder: Expert Consult - Online and Print, 4e (Shoulder (Rockwood/Matsen)(2 Vol.))(《肩关节外科学(第4版))之 第6章 肩关节的生物力学,提高了本人对肩关节生物力学原理的理解和认识,受益匪浅!
美国南加利福尼亚的Kenneth Blum在2009年10月的BMC Musculoskelet Disord(肌肉骨科疾病)杂志上撰文,探讨了肩关节肩袖损伤重建的相关问题。 文中称,不论是何种年龄、种族、身体状况、运动水平,肩关节肩袖损伤都是引起肩关节疼痛最常见的原因之一。仅仅在美国,每年就有超过600万的患者因肩关节问题寻求医疗救治。对于肩关节疼痛患者提供合适的治疗方案、理解肩关节疾病的机理机制、肩关节肩袖损伤重建后的康复中疼痛问题等等,都仍然是有着一系列的挑战。 全文链接: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777146/ BMC Musculoskelet Disord. 2009; 10 : 132. Published online 2009 October 29. doi: 10.1186/1471-2474-10-132 Repetitive H-Wave ® device stimulation and program induces significant increases in the range of motion of post operative rotator cuff reconstruction in a double-blinded randomized placebo controlled human study Kenneth Blum , Amanda LC Chen , Thomas JH Chen , Roger L Waite , B William Downs , Eric R Braverman , Mallory M Kerner , Stella M Savarimuthu ,and Nicholas DiNubile 江苏省徐州医学院附属医院骨科 关节镜、 膝肩关节外科、 骨科运动创伤 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
美国密西根大学医学中心影像科的Yoav Morag博士等在2006年第4期的北美影像学杂志《Radiographics》上撰文,总结了临床医师需要知道的肩袖损伤的核磁共振MRI影像学知识。 肩袖肌肉产生扭矩力来带动肱骨的活动,同时肩袖肌肉还要协调地产生平衡地压迫力来稳定盂肱关节。所以,肩袖损伤撕裂常常伴发肩关节力量的丧失和肩关节稳定性的丧失,而肩关节的力量和肩关节的稳定性对于维持肩关节最佳的功能非常关键。肩袖撕裂的范围和程度、受牵连肌腱的情况、撕裂的形态学特点、肩胛下肌和岗上肌肌腱的受牵连情况、毗邻结构(如:肩袖间隙、肱二头肌长头腱、特殊的肩袖肌腱等)受牵连情况、肌肉萎缩的证据等,这些都是肩袖需要治疗的适应症。核磁共振MRI能够显示出肩袖异常的程度和形态、能够显示出肩袖内部生物力学的不平衡、还能够记录肩袖肌肉的异常和毗邻结构的异常。 我们要全面掌握肩关节肩袖的解剖和功能、肩袖损伤的后果,这样才能给肩袖损伤患者提供最佳的治疗策略及较准确地指导预后。在肩袖核磁共振MRI读片时,要能鉴别出肩袖损伤、理解肩袖损伤的导致的潜在临床后续不良后果、报告出所有的相关影像学发现,这是非常重要的。 参考链接: 1、Pubmed http://www.ncbi.nlm.nih.gov/pubmed/16844931 2、杂志全文: http://radiographics.rsna.org/content/26/4/1045.long Radiographics. 2006 Jul-Aug;26(4):1045-65. MR imaging of rotator cuff injury: what the clinician needs to know. Morag Y , Jacobson JA , Miller B , De Maeseneer M , Girish G , Jamadar D . Source Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, TC-B1-132G, Ann Arbor, MI 48109-0326, USA. 江苏省徐州医学院附属医院骨科 关节镜、 膝肩关节外科、 骨科运动创伤 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
美国弗吉尼亚大学医学院骨科Diduch DR医师在2012年7月的Journal of the American Academy of Orthopaedic Surgeons(美国骨科医生学会杂志)上撰文,总结了肩关节镜盂肱关节手术中锚钉的应用。 关节镜手术已经成为治疗一些常见盂肱关节伤病(如肩袖损伤、盂唇损伤)的主流。关节镜下肩袖损伤修复、盂唇修复能够获得和传统切开手术相当的疗效。但是关节镜下手术比传统切开手术有更小的切口、更少的软组织干扰。组织锚钉和关节镜设备的开发和进步促使了关节镜下盂肱关节损伤修复的逐步流行与普及。当前的肩关节手术所用的锚钉可根据设计方式和材料组成分成不同的种类。 我们要认识这些器械的优势和局限,从而有利于指导我们更好地选择锚钉。 参考链接: 1、Pubmed链接: http://www.ncbi.nlm.nih.gov/pubmed/22751165 J Am Acad Orthop Surg. 2012 Jul;20(7):459-71. Tissue anchor use in arthroscopic glenohumeral surgery. Diduch DR , Scanelli J , Tompkins M , Milewski MD , Carson E , Ma SY . Source Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA. Abstract Arthroscopic surgery has become the mainstay of treatment of several common glenohumeral pathologies such as tears of the rotator cuff and labrum. Arthroscopic rotator cuff and labral repair provide outcomes comparable to those achieved with traditional open techniques, with the benefits of smaller incisions and less soft-tissue disruption. Development and improvement of tissue anchors and arthroscopic instrumentation has been integral to the increased popularity of arthroscopic glenohumeral repairs. Current anchors can be categorized by design and material composition. Awareness of the advantages and limitations of these implants may influence anchor selection. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
以色列骨科医师Chechik O等在2011年2月的Harefuah医学杂志上撰文,分析了肩关节初次前脱位。 文中称,年轻男性受创伤后常发生肩关节前脱位。肩关节前脱位常伴发骨折、肩袖损伤、及神经和血管损伤。然而,肩关节初次脱位的主要并发症是复发性肩关节不稳。经过体格检查和影像学检查后,采用多种方法都可以使肱骨头复位。这些不同方法的主要区别有:镇静、镇痛方法的不同;身体和上臂位置的不同;复位守法的不同;需要参与的医务人员数量的不同;成功率的不同;并发症的不同等。成功进行肩关节脱位复位后,上臂要固定在上肢悬吊带里面至少三周。 在年轻患者、活动多的患者,出现肩关节复发性脱位的风险因素较高,并且对肩关节的累积性损伤较重,所以对于年轻患者、活动多的患者可建议进行初次关节镜下修复手术。 参考文献: http://www.ncbi.nlm.nih.gov/pubmed/22164938 Harefuah. 2011 Feb;150(2):117-21, 206. . Chechik O , Khashan M , Amar E , Dolkart O , Mozes G , Maman E . Source Department of Orthopedic Surgery "B", Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
加利福尼亚圣地亚哥海军医学中心骨科的Provencher MT医生在2012年4月的Journal of the American Academy of Orthopaedic Surgeons(美国骨科医师学会杂志)上撰文,归纳总结了肩关节Hill-Sachs损伤的诊断、分类和治疗。 文中称,肩关节Hill-Sachs损伤是肱骨头的骨性缺损。肩关节Hill-Sachs损伤典型的特点是伴有肩关节前脱位。在肱盂关节不稳的患者中Hill-Sachs损伤的发生率相当高。在反复发作的肩关节前脱位患者中一般100%的患者具有Hill-Sachs损伤。反Hill-Sachs损伤在肩关节后向不稳的患者中有描述。在反复发作的肩关节前脱位患者中,肩盂骨缺损常和Hill-Sachs损伤(肱骨头的骨性缺损)同时存在。这种骨缺损是双极性的。为了使治疗Hill-Sachs损伤的临床疗效达到最优化,一定要注意鉴别是否同时存在肩盂的骨缺损。其它的病损情况(如Bankart损伤撕裂、关节盂唇或关节囊损伤)也要鉴别出来。 肩关节Hill-Sachs损伤的治疗要根据主观的和客观的肩关节不稳临床表现及影像学表现而定。非手术治疗,包括专业的康复锻炼,对于具有较小骨缺损的患者或步态严重的患者(如在一定的活动范围内肱盂关节仍然保持稳定的患者)能达到不错的治疗效果。对于肩关节Hill-Sachs损伤的手术治疗包括关节镜微创治疗和切开手术。 参考链接: http://www.ncbi.nlm.nih.gov/pubmed/22474094 J Am Acad Orthop Surg. 2012 Apr;20(4):242-52. The Hill-Sachs lesion: diagnosis, classification, and management. Provencher MT , Frank RM , Leclere LE , Metzger PD , Ryu JJ , Bernhardson A , Romeo AA . Source Department of Orthopaedic Surgery, Naval Medical Center, San Diego, CA, USA. Abstract The Hill-Sachs lesion is an osseous defect of the humeral head that is typically associated with anterior shoulder instability. The incidence of these lesions in the setting of glenohumeral instability is relatively high and approaches 100% in persons with recurrent anterior shoulder instability. Reverse Hill-Sachs lesion has been described in patients with posterior shoulder instability. Glenoid bone loss is typically associated with the Hill-Sachs lesion in patients with recurrent anterior shoulder instability. The lesion is a bipolar injury, and identification of concomitant glenoid bone loss is essential to optimize clinical outcome. Other pathology (eg, Bankart tear, labral or capsular injuries) must be identified, as well. Treatment is dictated by subjective and objective findings of shoulder instability and radiographic findings. Nonsurgical management, including focused rehabilitation, is acceptable in cases of small bony defects and nonengaging lesions in which the glenohumeral joint remains stable during desired activities. Surgical options include arthroscopic and open techniques. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝关节问题,更是给其带来希望、未来和新生!
美国纽约长老会医院骨科肩、肘及运动医学中心的Redler LH医师等在2012年2月的Physician and Sportsmedicine(医师与运动医学)杂志上撰文,归纳分析了当今膝关节软骨缺损的处理策略。 膝关节关节软骨损伤是临床上非常棘手的问题。对膝关节软骨损伤的治疗还存在很多争议。膝关节软骨是透明软骨,没有血管、低摩擦、高抗磨损表面,自我修复能力非常有限。目前还没有所谓最佳的软骨损伤软骨缺损的最佳治疗办法。现在多种治疗办法在被使用,目的是重建一个稳定的膝关节软骨表面。这些方法包括微骨折技术、自体或异体骨软骨移植技术、自体软骨种植技术、富含软骨细胞的基质种植技术及各种支架辅助技术。把握当前总的治疗原则,可以指导临床医师进行膝关节软骨损伤缺损的治疗。 在该文中,作者归纳了世界各地治疗软骨损伤缺损的研究疗效,也归纳了有关多种治疗方法的前瞻性随机对照研究。总结了当今世界膝关节软骨损伤的治疗指南。 参考链接: http://www.ncbi.nlm.nih.gov/pubmed/22508248 Phys Sportsmed. 2012 Feb;40(1):20-35. Management of articular cartilage defects of the knee . Redler LH , Caldwell JM , Schulz BM , Levine WN . Source Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY 10032, USA. Abstract Articular cartilage injuries of the knee present a difficult clinical dilemma and their treatment is controversial. Hyaline articular cartilage is an avascular, low-friction, and wear-resistant weightbearing surface that has limited capacity for self-repair. The optimal treatment for cartilage lesions has yet to be established. Various treatment methods are employed to reestablish a stable cartilage surface, including microfracture, autologous and allograft osteochondral transplantation, autologous chondrocyte implantation, matrix-associated chondrocyte implantation, and scaffold-assisted methods. Treatment algorithms help to guide physicians' decision making in the care of these injuries . In this article, results from outcomes studies as well as prospective randomized clinical trials comparing treatment methods are reviewed, and current practice guidelines are summarized. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 高绪仁:每天以解决膝关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝关节问题,更是给其带来希望、未来和新生!
新加坡樟宜医院(新加坡东部地区的医疗中心,亚洲首家采用关节镜治疗“网球肘”的医院)骨科的Yee Han Dave Lee 医师、日本神户大学骨科Ryosuke Kuroda医师、上海第六人民医院关节镜外科赵金忠主任、香港中文大学关节镜专家陈启明在2012年7月份的Sports Medicine, Arthroscopy, Rehabilitation, Therapy Technology(运动医学、关节镜、康复、治疗与技术杂志)上撰文,分享了他们在2010年度 ESSKA- APOSSM游学奖学金资助下,利用1个月的时间,在欧洲10家骨科运动医学中心参观学习膝关节前交叉韧带重建技术与理念的收获。 文中称,European Society of Sports Traumatology Knee Surgery and Arthroscopy(ESSKA 欧洲运动创伤、膝关节外科、关节镜学会)和Asia-Pacific Orthopaedic Society for Sports Medicine(APOSSM)(亚太骨科运动医学会)联合资助的游学奖学金项目目的是帮助医师更好地理解世界运动医学领域的流行病学、运动损伤的处理办法和手术技术。 膝关节前交叉韧带重建(ACL reconstruction)的技术和理念在不断演进。在世界各地最著名的膝关节前交叉韧带重建专家之间,在进行膝关节前交叉韧带重建时都有不同之处。 在一个月的项目资助期间,作者们在欧洲10家著名的骨科运动医学中心参观、感受了诸家不同的膝关节前交叉韧带重建技术。这些不同主要有:移植物的不同、固定方法的不同等。虽然各家有诸多的不同,但有一个相同点就是:进行膝关节前交叉韧带的解剖重建。 参考链接: 1、全文链接: http://www.smarttjournal.com/content/pdf/1758-2555-4-27.pdf 2、Pubmed链接: http://www.ncbi.nlm.nih.gov/pubmed/22839644 Sports Med Arthrosc Rehabil Ther Technol. 2012 Jul 28;4(1):27. A tale of 10 European centres - 2010 APOSSM travelling fellowship review in ACL surgery. Lee YH , Kuroda R , Zhao JZ , Chan KM . Abstract ABSTRACT: The purpose of ESSKA- APOSSM Travelling fellowship is to better understand the epidemiology, management and surgical techniques for sports across continents. There has been a progressive evolution in ACL reconstruction and there is variation in technique in ACL reconstruction amongst the most experienced surgeons in different continents. During this one month fellowship, we saw various ACL reconstruction techniques using different graft sources, with a variety of graft fixation methods, with the common aim of recreating an anatomical ACL reconstruction. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
新西兰的Masters S医生和 Burley S医生在2007年7月的Aust Fam Physician(澳大利亚家庭医生)杂志上撰文,分析了肩关节疼痛的诊断和治疗。 文中称,在全科医师的门诊中,经常可以遇到肩关节疼痛的患者。肩关节疼痛常可由急性疼痛转变为慢性肩关节疼痛。肩关节疼痛患者的临床表现常包括:疼痛、无力或僵硬,有的患者也是以上两到三种症状同时出现。该文总结了一条诊断和治疗肩关节疼痛及肩关节周围组织结构疼痛的流程。全面采集病史(包括患者的社会、心理情况)和熟练的肩关节体格检查技能非常重要。其他专门的检查对全科医师诊断肩关节疼痛时的影像不大。肩关节急性疼痛可能转变为慢性疼痛的趋势(生物方面和心理方面都是这个转变的危险因素)意味着医生在从多种治疗方法中选择合适的治疗方法时要采用个体化、以病人为中心的方法。 参考链接: 1、全文链接: http://www.racgp.org.au/afp/200706/200706masters.pdf 2、Pubmed链接: http://www.ncbi.nlm.nih.gov/pubmed/17565397 Aust Fam Physician . 2007 Jun;36(6):414-6, 418-20. Shoulder pain. Masters S , Burley S . Source University of Otago, New Zealand. Abstract BACKGROUND: Shoulder pain is common in general practice and is a condition that frequently becomes chronic. Presentation includes either pain, weakness and stiffness, or a combination of these symptoms. OBJECTIVE: This article presents a systematic approach to diagnosing and managing disorders of the shoulder joint and surrounding structures. DISCUSSION: Thorough history taking (including psychosocial aspects) and skilled examination are essential; special investigations rarely affect the general practitioner's management of shoulder pain. The tendency toward chronicity of shoulder pain (increased by certain biological and psychosocial risks) means that the clinician should adopt a patient centred approach in choosing from a wide range of treatment modalities. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
印度芒格洛尔 的影像学医师Priyank S Chatra在2012年1月份的Indian J Radiol Imaging(印度放射影像学)杂志上撰文,归纳总结了膝关节周围常见的滑囊及其核磁共振MRI影像学表现。 滑囊是一种充满液体的囊性组织结构。滑囊多位于皮肤和肌腱之间或肌腱和骨骼之间。滑囊主要的功能是减少附近相邻可运动性结构之间的摩擦。膝关节周围的滑囊可分为髌骨周围滑囊和其它位置的滑囊。 该文中,作者描述了最常见的各种膝关节周围滑囊病变及其核磁共振MRI影像学表现。 参考链接: 1、全文链接: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354353/?tool=pubmed 2、Pubmed链接: http://www.ncbi.nlm.nih.gov/pubmed/22623812 Indian J Radiol Imaging. 2012 Jan;22(1):27-30. Bursae around the knee joints . Chatra PS . Source Department of Radiology, Yenepoya Medical College, Mangalore, Karnataka, India. Abstract A bursa is a fluid-filled structure that is present between the skin and tendon or tendon and bone. The main function of a bursa is to reduce friction between adjacent moving structures. Bursae around the knee can be classified as those around the patella and those that occur elsewhere. In this pictorial essay we describe the most commonly encountered lesions and their MRI appearance. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
澳大利亚昆士兰运动医学专家Shane Brun于2012年4月份的Australian Family Physician(澳大利亚家庭医生杂志)上撰文,提出了肩关节损伤的初步病情评估流程。 在澳大利亚的初级保健医疗机构(社区医院),肩关节损伤的患者很多。然而对于开业的全科医生而言,在诊断肩关节疼痛时知识往往不够,故常显得不够自信。本文总结了一个对肩关节损伤的患者进行初步病情评估时的框架流程图。深刻理解肩关节的解剖和肩关节的独特特点对于准确把握肩关节各种损伤非常重要。全面准确把握患者的病史对于探究损伤的机制、功能障碍的类型和疼痛的根源是非常必要的。 在进行肩关节的体格检查时,要特别注意:1、双肩是否不对称?2、肩关节压痛的位置在哪里?3、肩关节的活动范围如何? 参考链接: 1、全文链接: http://www.racgp.org.au/afp/201204/201204brun1.pdf 2、Pubmed链接: http://www.ncbi.nlm.nih.gov/pubmed/22472683 Aust Fam Physician. 2012 Apr;41(4):217-20. Initial assessment of the injured shoulder . Brun S . Source Musculoskeletal Sports Medicine, Clinical Skills Unit, School of Medicine and Dentistry, James Cook University, Queensland. Abstract BACKGROUND: Shoulder injuries are common in the primary care setting, yet general practitioners may feel unequipped to confidently assess the patient presenting with shoulder pain. OBJECTIVE: This article provides a framework for the initial assessment of a patient presenting with an injured shoulder . DISCUSSION: A solid understanding of the anatomy and unique features of the shoulder is important to adequately assess any injury. A focused history needs to particularly explore the mechanism of injury, the type of dysfunction and the nature of the pain. On examination, particular attention should be paid to loss of symmetry, localisation of tenderness and the range of movement. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
法国儿童骨科医师Bouju Y在2011年11月份的Orthopaedics Traumatology: Surgery Research(骨科和创伤学:手术与研究杂志)撰文,分析儿童膝关节半月板创伤性损伤核磁共振MRI检查结果和关节镜检查结果的一致性。 儿童出现创伤性膝关节半月板损伤时必须尽快、优先诊断明确。因为这有助于对膝关节半月板的保护并有助于保护整个膝关节的未来。儿童膝关节半月板损伤常常单独存在、难于在临床上诊断明确。在儿童膝关节半月板损伤的诊断上,常规多积极借助于关节镜进行明确诊断,但现在放射科医师越来越多地借助于核磁共振MRI来诊断儿童膝关节半月板的损伤。本文主要研究在儿童半月板损伤时核磁共振MRI检查和关节镜检查的检查结果的是否具有一致性。作者进行了一个回顾性研究。1995年到2008年,9到16岁的儿童,共计69个膝关节进行了核磁共振MRI检查,也随后进行了关节镜探查。 本组研究将盘状半月板排除在外。一名临床医师总结所有的相关病历。一名专攻儿童病理的放射科医师总结了所有的相关核磁共振MRI影像。骨骺闭合的病例被排除在外。所有的相关病历都是可供分析的。关节镜下检查的检查作为参照物,评估半月板损伤的表现、半月板损伤的位置和半月板损伤的类型。第一次进行核磁共振MRI检查结果读片和第二次进行核磁共振MRI检查结果读片和关节镜的检查结果总的一致性分别是78%和82% 。第一次进行核磁共振MRI检查结果读片和第二次进行核磁共振MRI检查结果读片和关节镜的检查结果对内侧 半月板来说一致性分别是:77% 和 80% 。第一次进行核磁共振MRI检查结果读片和第二次进行核磁共振MRI检查结果读片和关节镜的检查结果对外侧半月板来说一致性分别是:78% 和 84%。 在第一次读片时,内测半月板有13个假阳性损伤、外侧半月板有5个假阳性损伤。在第二次读片时,内测半月板有9个假阳性损伤、外侧半月板有0个假阳性损伤。在第一次读片时,总的敏感性是70% 。在第二次读片时,总的敏感性是64% 。在第一次读片时,总的特异性是81% 。在第二次读片时,总的特异性是90% 。 本研究的结果,和既往文献相符合,鼓舞人心,证明了核磁共振对诊断膝关节半月板损伤的有效性。但是在分析内侧半月板和外侧半月板时也隐藏着很多不一致的东西:如核磁共振可能过高地评估了内侧半月板的损伤、过低地评估了外侧半月板的损伤。 该文的结论是:膝关节核磁共振MRI检查只是提供半月板损伤的的一个辅助诊断方法,而不能完全准确地反映出半月板损伤的情况。对膝关节核磁共振影像学结果的解读要结合临床体格检查和儿童骨科专家的临床经验。 参考链接: http://www.ncbi.nlm.nih.gov/pubmed?term=The%20concordance%20of%20MRI%20and%20arthroscopy%20in%20traumatic%20meniscal%20lesions%20in%20children Orthop Traumatol Surg Res. 2011 Nov;97(7):712-8. Epub 2011 Oct 13. The concordance of MRI and arthroscopy in traumatic meniscal lesions in children . Bouju Y , Carpentier E , Bergerault F , De Courtivron B , Bonnard C , Garaud P . Source Pediatric Orthopedics Department, Clocheville Hospital, Tours University Hospital Center, 37044 Tours cedex, France. Abstract INTRODUCTION: Traumatic meniscal lesions in children must be diagnosed quickly and efficiently as a priority in order to conserve the meniscus and safeguard the future of the knee. They are often isolated and difficult to identify clinically. In the diagnostic work up stage, an excessive resort to diagnostic arthroscopy has given way to increasing use of MRI by radiologists without pediatric specialization. The present study examined the agreement between MRI aspect and arthroscopic exploration in traumatic meniscal lesions in children . PATIENTS AND METHODS: Sixty-nine knees in children aged 9 to 16 years having undergone MRI followed by arthroscopy for knee trauma between 1995 and 2008 were included in a retrospective design. Discoid meniscus was excluded. Files were reviewed by a single clinician and MRI scans by a radiologist specialized in pediatric pathology. Cases of epiphyseal fusion were excluded. All files were analyzable. Agreement with arthroscopic findings as reference was assessed for presence, location and type of meniscal lesion. RESULTS: Overall agreement with arthroscopy was respectively 78% and 82% on first and second MRI readings: 77% and 80% for the medial, and 78% and 84% for the lateral meniscus. On the first reading, there were 13 false positives for the medial and 5 for the lateral meniscus, versus 9 and 0 respectively on second reading. Overall sensitivity was 70% on first reading and 64% on second, and overall specificity 81% and 90%, respectively. DISCUSSION: The present results, in line with the literature, may appear encouraging, but hide considerable disparity between analysis of the medial and of the lateral meniscus: MRI overestimated medial and underestimated lateral meniscus lesions . CONCLUSION: MRI serves only as a support and does not provide sure diagnosis of meniscus lesion. Interpretation should take account of the clinical examination and the pediatric orthopedic specialist's experience. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
以色列的一家关节镜与运动医学中心Haviv B医生于2012年3月的Harefuah(以色列医学会医学杂志)上撰文,对具有症状的肩关节肩袖损伤进行了归纳总结。 文中称,肩关节肩袖损伤在中老年患者中非常常见。肩关节肩袖损伤会导致肩关节慢性疼痛。五十几岁、六十几岁、七十几岁和八十几岁人群中肩关节肩袖损伤的发生率分别为12.8%, 25.6%, 45.8% 和50%。 肩袖损伤的病因机理可分为两类。即:1、内源性原因(如:反复的微创伤);2、外源性原因(如:肩峰下撞击)。对于有症状的肩袖损伤患者来说,肩峰下滑囊可能是致痛来源。因为无症状的肩袖损伤很多,所以现在还不能确定是不是肩袖损伤本身就能够引起疼痛。肩关节疼痛和无力的症状是逐渐增加的,然而,受到一个创伤后,肩关节疼痛和无力的症状会突然急性发作。肩袖损伤常出现上肢上举过头困难,并常出现夜间疼痛。对肩关节肌肉肌力的评估可以初步诊断出来是不是肩袖损伤撕裂。普通的肩关节X线片对排除肩关节其它诊断是很重要的。超声检查和核磁共振MRI检查能够进一步确诊肩袖的撕裂,然而,当对指导治疗有必要时再进行超声检查和核磁共振检查。外科手术治疗的常见适应症是:相对年轻和活动多的患者的急性肩袖撕裂;或者是当对慢性撕裂治疗采用其它治疗方法无效的时候。 现在,大部分的肩袖损伤都是在全关节镜下完成的。肩关节镜治疗肩袖损伤具有创伤小、康复快、疼痛轻的特点。 参考链接: http://www.ncbi.nlm.nih.gov/pubmed/22741212 Harefuah. 2012 Feb;151(2):102-6, 126. . Haviv B , Bronak S , Thein R . Source Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, Petach Tikva, Israel. Abstract Rotator cuff tears of the shoulder are common in the middle age and elderly population and can cause chronic pain. The prevalence of rotator cuff tears in people in their 50s, 60s, 70s, and 80s is 12.8%, 25.6%, 45.8% and 50% respectively. Etiological theories for tear evolvement are divided into intrinsic (e.g. recurrent microtrauma) and extrinsic (e.g. subacromial impingement). The subacromial bursa is probably the source of pain in symptomatic patients with rotator cuff tear. It is uncertain whether the tear itself can produce pain because of the high prevalence of asymptomatic tears. The symptoms are of gradual increase in shoulder pain and weakness, however, it can happen acutely due to an injury. Difficulties in overhead activities and night pain are common. Evaluation of shoulder muscle strength can imply on cuff tear. Shoulder radiograph is essential specifically to rule out other diagnosis. Imaging such as ultrasound and magnetic resonance can further define the tear, however they should be used only if they will affect the management of the condition. Common indications for surgical repair are acute tear in a relatively young and active patient or when the treatment of symptomatic patient with chronic tear had failed. Most repairs are currently performed in an all arthroscopic technique which is minimally invasive with easier rehabilitation and less pain. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
美国俄亥俄州立大学骨科的Bellisari Greg等在2011年3月份的Sports medicine and arthroscopy review(运动医学和关节镜评论)杂志上撰文,总结了儿童膝关节半月板损伤撕裂的情况。 随着骨科未发育成熟儿童、青少年参加体育活动的机会增加,随着医生对半月板损伤认识的加深,儿童、青少年发生半月板损伤检出率在增加。因为在年轻的患者,半月板损伤会产生长期的后续不良后果,所以加强对半月板损伤的认识和提高半月板损伤的治疗效果是非常重要的。 本文中作者总结了膝关节半月板的解剖、膝关节半月板的发育,回顾了半月板撕裂损伤的分类和诊断方法,讨论了膝关节半月板损伤各种治疗方法的选择及各种治疗方法的治疗效果情况,并重点讨论了儿童膝关节外侧盘状半月板和半月板囊肿。 参考链接:1、杂志链接 http://journals.lww.com/sportsmedarthro/toc/2011/03000 2、Pubmed链接 http://www.ncbi.nlm.nih.gov/pubmed/21293238 Sports Med Arthrosc. 2011 Mar;19(1):50-5. Meniscus tears in children. Bellisari G , Samora W , Klingele K . Source Department of Orthopaedics, The Ohio State University, Columbus, OH, USA. Abstract Increased athletic participation by the skeletally immature athlete and a heightened suspicion by physicians have contributed to an increase in the incidence of meniscal injuries in children and adolescents. In young patient, meniscal injury could have long-term consequences, so an understanding of recognition and treatment is essential. We review the anatomy and development of the menisci, review classification and diagnosis of meniscal tears, discuss management options and outcomes of treatment, and focus on discoid lateral meniscus and meniscal cysts . 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
美国加利福尼亚大学骨科Drew A. Lansdown医师和Brian T. Feeley医师在2012年5月份的The Physician and Sportsmedicine(医师与运动医学)杂志上撰文,回顾了肩关节肩袖损伤的诊断和治疗方法。 在美国,肩关节肩袖损伤是非常常见的。肩关节肩袖损伤是患者来到初级保健医师处就诊的常见原因。现在看,肩关节肩袖损伤更易发生在老年人身上。肩袖的组成肌肉能够使上臂完成举过头顶的动作,并且能够控制肩关节活动。全面的体格检查能够得出肩袖损伤的诊断。影像学检查能够让我们更深刻地理解肩关节肩袖损伤的内部病理改变。核磁共振MRI检查能够让我们清晰地看到肩袖。很多肩袖撕裂,特别是部分撕裂,在保守治疗后症状能够有所缓解。对于保守治疗效果欠佳的肩关节肩袖损伤患者来说,外科手术治疗可能能够减轻患者的肩关节疼痛、提高肩关节的功能活动范围。对于肩袖不能修补的患者,可以采用反置式人工全肩关节置换术进行治疗。 新的科技发展促使研究人员考虑在肩袖损伤治疗中采用生物学增强的办法,但这一方法还处在研究之中。 参考链接:1、杂志链接 https://www.physsportsmed.org/doi/10.3810/psm.2012.05.1967 2、Pubmed链接 http://www.ncbi.nlm.nih.gov/pubmed/22759608 Phys Sportsmed. 2012 May;40(2):73-86. Evaluation and treatment of rotator cuff tears. Lansdown DA , Feeley BT . Source Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA 94158, USA. Abstract Rotator cuff injuries are common problems and a frequent reason for patients to present to primary care physicians. These injuries are seen more frequently now with the aging population. These muscles allow for movement of the arm in overhead activities and controlled movements through space. A thorough physical examination can lead to the diagnosis of rotator cuff pathology. Radiographic imaging may offer some insight into the underlying pathology, and magnetic resonance imaging provides for excellent visualization of the rotator cuff. Many rotator cuff tears, especially partial tears, will symptomatically improve with conservative management. Surgical treatment may offer improved pain relief and function in those patients for whom nonoperative care is insufficient. In cases in which rotator cuff repair is not possible, the reverse total shoulder arthroplasty is a possibility. New technologies are also under investigation that allow for biological augmentation of rotator cuff tears. 江苏省徐州医学院附属医院骨科 关节镜、 膝关节外科、 骨科运动医学 方向 高绪仁 编译 高绪仁:每天以解决膝、肩关节问题为乐:) 每天努力提高自己的技术和服务水平 不仅仅是解决其膝、肩关节问题,更是给其带来希望、未来和新生!
下面我翻译一篇比较好的文章,这篇文章来自弗吉尼亚联邦大学医学院物理治疗科,这篇文章告诉大家怎样才能确诊肩峰撞击综合征,怎样排除SAIS。 标题:Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. 标题:肩峰撞击综合征5种特殊检查及其联合检查的可靠性和诊断的准确性 Michener LA, Walsworth MK, Doukas WC, Murphy KP. Department of Physical Therapy, Virginia Commonwealth University, Medical College of Virginia, PO Box 980224, Richmond, VA 23298, USA. lamichen@vcu.edu Abstract 摘要 OBJECTIVE: To investigate the reliability and diagnostic accuracy of individual tests and combination of tests for subacromial impingement syndrome (SAIS). 目的:评估肩峰撞击综合征每个特殊试验及其联合试验的信度和诊断的准确性 DESIGN: A prospective, blinded study design. 方案:预期,双盲试验 PARTICIPANTS: Patients with shoulder pain (n=55, mean age=40.6y). 受试者:肩痛患者(n=50,平均年龄=40.6岁) INTERVENTIONS: Patients were evaluated with 5 physical examination tests for SAIS: Neer, Hawkins-Kennedy, painful arc, empty can (Jobe), and external rotation resistance tests. Surgical diagnosis was the reference standard. 介入方法:患者依次被做检查5种肩峰撞击综合征特殊试验:Neer 试验, Hawkins-Kennedy 试验, 疼痛弧试验,空罐头试验(Jobe), 和外旋抵抗试验。 MAIN OUTCOME MEASURES: Diagnostic accuracy calculated with a receiver operating characteristic (ROC) curve and sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR). A forward stepwise binary logistic regression analysis was used to determine the best test combination for SAIS. An ROC curve analysis was also used to determine the cut point of the number of tests discriminating between the presence and absence of SAIS. Kappa coefficients and percent agreement assessed interrater reliability. 主要测试方法:诊断的准确性由ROC曲线测量、以及敏感性、特殊性、阳性率和阴性率。多因素二元logistic回归分析用来确定肩峰撞击综合征最佳的特殊试验。ROC曲线分析用来确定肩峰撞击综合征的真阳性率和假阳性率,Kappa系数作为一致性检验。 RESULTS: The ROC analyses revealed a significant area under the curve (AUC) (AUC=.67-.72, P.05) for all tests, except for the Hawkins-Kennedy. The tests with a +LR greater than or equal to 2.0 were the painful arc (+LR=2.25; 95% CI, 1.33-3.81), empty can (+LR=3.90; 95% CI, 1.5-10.12), and the external rotation resistance tests (+LR=4.39; 95% CI, 1.74-11.07). Tests with -LR less than or equal to 0.50 were the painful arc (-LR=.38; 95% CI, .16-.90), external rotation resistance (-LR=.50; 95% CI, .28-.89), and Neer tests (-LR=.35; 95% CI, .12-.97). The regression analysis had no specific test combinations for confirming or ruling out SAIS. The ROC analysis was significant (AUC=.79, P=.001), with a cut point of 3 positive tests out of 5 tests. Reliability was moderate to substantial agreement (kappa=.45-.67) for the painful arc, empty can, and external rotation resistance tests and fair strength of agreement (kappa=.39-.40) for the Neer and Hawkins-Kennedy tests. 结果:ROC曲线说明了除了Hawkins-Kennedy试验外,所有试验的曲线下面积有显著意义(AUC=.67-.72, P.05)。阳性率大于等于2.0的试验是疼痛弧试验(+LR=2.25; 95% CI, 1.33-3.81),空罐头试验(+LR=3.90; 95% CI, 1.5-10.12)和外旋抵抗试验(+LR=4.39; 95% CI, 1.74-11.07)。阴性率小于等于0.50的试验是疼痛弧试验(-LR=.38; 95% CI, .16-.90), 外旋抵抗试验(-LR=.50; 95% CI, .28-.89), 和Neer 试验(-LR=.35; 95% CI, .12-.97)。回归分析显示没有特殊试验组合确定或排除SAIS。ROC曲线分析3/5试验阳性具有显著意义(AUC=.79, P=.001),疼痛弧试验、空罐头试验和外旋抵抗试验具有良好相关性(kappa=.45-.67),Neer试验和 Hawkins-Kennedy 试验具有中等的相关性(kappa=.39-.40)。 CONCLUSIONS: The single tests of painful arc, external rotation resistance, and Neer are useful screening tests to rule out SAIS. The single tests of painful arc, external rotation resistance, and empty can are helpful to confirm SAIS. The reliability of all tests was acceptable for clinical use. Based on reliability and diagnostic accuracy, the single tests of the painful arc, external rotation resistance, and empty can have the best overall clinical utility. The cut point of 3 or more positive of 5 tests can confirm the diagnosis of SAIS, while less than 3 positive of 5 rules out SAIS. 结论:疼痛弧试验、外旋抵抗试验和Neer试验对筛选排除SAIS较有用。疼痛弧试验、外旋抵抗试验和空罐头试验对确诊SAIS较有用。这五种试验的信度在临床上都可以被接受。基于信度与诊断的准确性,疼痛弧试验、外旋抵抗试验和空罐头试验临床的使用价值最大。这5种试验中的3种试验阳性便可以确诊SAIS,然而5个试验中少于3种试验阳性便可以排除SAIS。 表1五种肩峰撞击征特殊试验的可靠性系数Kappa值 表2. 肩峰撞击征试验诊断的准确性 表3.联合试验诊断的准确性 表4. 每个特殊试验及联合试验队肩峰撞击征确诊的概率和排除的概率 文章PubMed链接: http://www.ncbi.nlm.nih.gov/pubmed/19887215