Surgical treatment of superior labral anterior posterior(SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both,imaging and surgical technique as well as implants.The first c...Surgical treatment of superior labral anterior posterior(SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both,imaging and surgical technique as well as implants.The first classification of SLAP lesions was described in 1990, a subdivision in four types existed. The rising comprehension of pathology and pathophysiology in SLAP lesions contributed to increase the types in SLAP classification to ten. Concerning the causative mechanism of SLAP lesions, acute trauma has to be differed from chronic degeneration. Overhead athletes tend to develop a glenohumeral internal rotation deficit which forms the basis for two controversial discussed potential mechanisms of pathophysiology in SLAP lesions: Internal impingement and peel-back mechanism. Clinical examination often remains unspecific whereas soft tissue imaging such as direct or indirect magnetic resonance arthrography has technically improved and is regarded to be indispensable in detection of SLAP lesions. Concomitant pathologies as Bankart lesions, rotator cuff tears or perilabral cysts should be taken into consideration when planning a personalized therapeutic strategy. In addition, normal variants such as sublabral recess, sublabral hole, Buford complex and other less common variants have to be distinguished. The most frequent SLAP type Ⅱ needs a sophisticated approach when surgical teatment comes into consideration. While SLAP repair is considered to be the standard operative option, overhead athletes benefit from a biceps tenodesis because improved patient-reported satisfaction and higher rate of return to pre-injury level of sports has been reported.展开更多
Objective:To review the literature regarding diagnosis and treatment of labral tear.Data sources:A systematic search was performed in PubMed using various search terms and their combinations including hip,labrum,aceta...Objective:To review the literature regarding diagnosis and treatment of labral tear.Data sources:A systematic search was performed in PubMed using various search terms and their combinations including hip,labrum,acetabular labral tear,arthroscopy,diagnosis,and anatomy.Study selection:For each included study,information regarding anatomy,function,etiology,diagnosis,and management of acetabular labral tear was extracted.Results:Five hundred and sixty abstracts about anatomy,function,etiology,diagnosis,and management of acetabular labral tear were reviewed and 66 selected for full-text review.The mechanism of labral tear has been well explained while the long-term outcomes of various treatment remains unknown.Conclusions:Labral tear is generally secondary to femoroacetabular impingement,trauma,dysplasia,capsular laxity,and degeneration.Patients with labral tear complain about anterior hip or groin pain most commonly with a most consistent physical examination called positive anterior hip impingement test.Magnetic resonance arthrography is a reliable radiographic examination with arthroscopy being the gold standard.Conservative treatment consists of rest,non-steroidal anti-inflammatory medication,pain medications,modification of activities,physical therapy,and intra-articular injection.When fail to respond to conservative treatment,surgical treatment including labral debridement,labral repair,and labral reconstruction is often indicated.展开更多
目的观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。...目的观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。在关节镜下采用可吸收带线锚钉修复盂唇。采用视觉模拟评分(visual analogue scale,VAS)评价疼痛,美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分系统和Rowe肩关节评分系统评价关节功能。结果两组患者术后VAS评分、ASES评分和Rowe评分均优于术前(P<0.05),没有脱位复发。两组患者术后结果的差异无统计学意义(P>0.05)。结论对V型SLAP损伤的复发性肩关节前脱位,采用可吸收带线锚钉进行修复可获得良好的临床效果。展开更多
文摘Surgical treatment of superior labral anterior posterior(SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both,imaging and surgical technique as well as implants.The first classification of SLAP lesions was described in 1990, a subdivision in four types existed. The rising comprehension of pathology and pathophysiology in SLAP lesions contributed to increase the types in SLAP classification to ten. Concerning the causative mechanism of SLAP lesions, acute trauma has to be differed from chronic degeneration. Overhead athletes tend to develop a glenohumeral internal rotation deficit which forms the basis for two controversial discussed potential mechanisms of pathophysiology in SLAP lesions: Internal impingement and peel-back mechanism. Clinical examination often remains unspecific whereas soft tissue imaging such as direct or indirect magnetic resonance arthrography has technically improved and is regarded to be indispensable in detection of SLAP lesions. Concomitant pathologies as Bankart lesions, rotator cuff tears or perilabral cysts should be taken into consideration when planning a personalized therapeutic strategy. In addition, normal variants such as sublabral recess, sublabral hole, Buford complex and other less common variants have to be distinguished. The most frequent SLAP type Ⅱ needs a sophisticated approach when surgical teatment comes into consideration. While SLAP repair is considered to be the standard operative option, overhead athletes benefit from a biceps tenodesis because improved patient-reported satisfaction and higher rate of return to pre-injury level of sports has been reported.
文摘Objective:To review the literature regarding diagnosis and treatment of labral tear.Data sources:A systematic search was performed in PubMed using various search terms and their combinations including hip,labrum,acetabular labral tear,arthroscopy,diagnosis,and anatomy.Study selection:For each included study,information regarding anatomy,function,etiology,diagnosis,and management of acetabular labral tear was extracted.Results:Five hundred and sixty abstracts about anatomy,function,etiology,diagnosis,and management of acetabular labral tear were reviewed and 66 selected for full-text review.The mechanism of labral tear has been well explained while the long-term outcomes of various treatment remains unknown.Conclusions:Labral tear is generally secondary to femoroacetabular impingement,trauma,dysplasia,capsular laxity,and degeneration.Patients with labral tear complain about anterior hip or groin pain most commonly with a most consistent physical examination called positive anterior hip impingement test.Magnetic resonance arthrography is a reliable radiographic examination with arthroscopy being the gold standard.Conservative treatment consists of rest,non-steroidal anti-inflammatory medication,pain medications,modification of activities,physical therapy,and intra-articular injection.When fail to respond to conservative treatment,surgical treatment including labral debridement,labral repair,and labral reconstruction is often indicated.
