Open latarjet procedure versus all-arthroscopic autologous tricortical iliac crest bone grafting for anterior-inferior glenohumeral instability with glenoid bone loss.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Surgery Pub Date : 2022-09-01 DOI:10.1177/10225536221133946
Sam Razaeian, Katja Tegtmeier, Dafang Zhang, Stefan Bartsch, Peter Kalbe, Christian Krettek, Nael Hawi
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Abstract

Purpose: The purpose of this study is to compare the open Latarjet procedure versus the all-arthroscopic autologous tricortical iliac crest bone grafting (AICBG) technique for recurrent anterior-inferior glenohumeral instability with glenoid bone loss.

Methods: All open Latarjet and AICBG procedures for recurrent anterior-inferior shoulder instability with glenoid bone loss performed at two institutions between September 2015 and April 2019 were retrospectively analyzed. Inclusion criteria were a traumatic etiology, a glenoid surface deficiency >13.5%, and a minimum follow-up (FU) of 18 months. Primary outcomes included the subjective shoulder value, the Western Ontario Shoulder Instability (WOSI), Rowe scores including subdomains, and the four subdomains of the Constant score (pain, activities of daily living, internal rotation, external rotation). Secondary outcomes were subjective shoulder instability, EQ-5D-3 L, pain level on the VAS, level of overall satisfaction, operative time, return-to-work rate, and return-to-sports rate.

Results: Forty-three patients were available for final analysis (Latarjet: n = 21; AICBG: n = 22) at an average FU of 34.9 months (range, 22-66 months). Both techniques provided good outcomes and improved stability. The Rowe score, Rowe-range of motion, and CS-internal rotation (p = 0.008, p<0.001, p = 0.001) were slightly better in the AICBG group. Furthermore, the WOSI physical symptoms subdomain was significantly better (p = 0.04) in the AICBG group, while its total score did not reach statistical significance (p = 0.07). There was no statistically significant difference in the secondary outcomes besides operative time, which was significantly shorter in the Latarjet procedure group (p = 0.04). Overall complication rate was similar in both groups (Latarjet: 9.5% (n = 2), AICBG: 9.1% (n = 2)).

Conclusion: Open Latarjet and AICBG procedures provide comparable clinical outcomes except for significantly better Rowe score, Rowe-range of motion, WOSI physical symptoms subdomain, and internal rotation capacity in the AICBG group. However, these results should be carefully interpreted in the context of known minimal clinically important differences of these scores.

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开放椎弓根手术与全关节镜下自体三皮质髂骨植骨治疗肩关节前下不稳定伴肩关节骨丢失。
目的:本研究的目的是比较开放Latarjet手术与全关节镜下自体三皮质髂骨移植(AICBG)技术治疗复发性肱骨前下不稳定伴盂骨丢失。方法:回顾性分析2015年9月至2019年4月在两家机构进行的所有开放性Latarjet和AICBG手术治疗复发性前下肩不稳伴肩关节骨丢失的病例。入选标准为外伤性病因,关节盂表面缺损>13.5%,最低随访时间为18个月。主要结果包括主观肩部值、西安大略省肩部不稳定性(WOSI)、Rowe评分包括子域,以及Constant评分的四个子域(疼痛、日常生活活动、内旋、外旋)。次要结果是主观肩部不稳定性、eq - 5d - 3l、VAS疼痛水平、总体满意度、手术时间、重返工作率和重返运动率。结果:43例患者可用于最终分析(Latarjet: n = 21;AICBG: n = 22),平均FU 34.9个月(范围22-66个月)。两种技术均提供了良好的结果,并提高了稳定性。AICBG组Rowe评分、Rowe-活动范围和cs -内旋(p = 0.008, pp = 0.001)稍好。此外,AICBG组的WOSI身体症状子域明显优于AICBG组(p = 0.04),而其总分无统计学意义(p = 0.07)。除手术时间外,两组的次要结局无统计学差异(p = 0.04), Latarjet组的手术时间明显缩短。两组的总并发症发生率相似(Latarjet: 9.5% (n = 2), AICBG: 9.1% (n = 2))。结论:开放Latarjet和AICBG手术提供了相当的临床结果,除了AICBG组明显更好的Rowe评分、Rowe运动范围、WOSI身体症状亚域和内旋能力。然而,这些结果应该在已知这些评分的最小临床重要差异的背景下仔细解释。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Surgery
Journal of Orthopaedic Surgery ORTHOPEDICS-SURGERY
CiteScore
3.10
自引率
0.00%
发文量
91
审稿时长
13 weeks
期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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