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锐健REJOIN

锐健医疗

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上关节囊重建术

上关节囊重建术 Superior Capsule Reconstruction Reconstrucción de Cápsula Superior

手术概要 Surgery overview Resumen de la cirugía
SCR技术要点: 1. 肩峰成型是必须的; 2. 肩胛下肌撕裂需修补; 3. 使用探钩测量关节囊,注意测量出的长度可能小于实际,因为关节囊弧形而探钩是直线; 4. 移植物应该大而厚为好; 5. 注意前侧边边缝合时张力不要过大,以防止撕裂,但如果内、后、外都很好地缝合了,则前侧无需缝合; 6. 对于翻修的病例,大结节上已经有很多钉子,建议用穿骨技术,将移植物固定在大结节上; 7. 如果关节镜技术不熟练的医生,开放手术重建上关节囊也可行; 8、术后6----12个月的康复期; 9、三角肌力量的正常,可提升术后肩关节的功能。 SCR technical highlights: 1. subacromial decompression needs be performed. 2. Subscapularis tear to be repaired 3. Measure with probe. 4. The SCR graft preferrablely to be thicker. 5. Do not over-tension the graft at the anterior lateral side. If the graft is well stiched at medial, lateral, and posterior margins, anterior attachment is not necessary. 6. For revision cases, transossessous repair is recommended to avoid the existing suture anchors in the GT. 7. Arhroscopic SCR is a complicated case. Mini-open SCR would save more operating time. 8. Recovery takes about 6 to 12 months post-operatively. 9. Healthy deltoid could contribute to post-op shoulder functional recovery. Key Technical Points of SCR (Superior Capsular Reconstruction): Acromioplasty is mandatory. Repair any subscapularis tendon tears. Use a probe to measure the joint capsule. Note: The measured length may be shorter than the actual length because the capsule is curved while the probe is straight. The graft should be large and thick for optimal results. When suturing the anterior edge, avoid excessive tension to prevent tearing. However, if the medial, posterior, and lateral sides are well-sutured, anterior suturing may be unnecessary. For revision cases with multiple existing anchors on the greater tuberosity, consider transosseous fixation to secure the graft. If arthroscopic proficiency is limited, open surgical reconstruction of the superior capsule is an acceptable alternative. Postoperative rehabilitation typically takes 6–12 months. Normal deltoid muscle strength can enhance postoperative shoulder function.
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