A. K. Orletskiy, D. O. Timchenko, N. A. Gordeev, Vladislav A. Zharikov, E. S. Kozlova, S. Krylov
{"title":"Surgical treatment of post-traumatic instability of the shoulder joint in athletes","authors":"A. K. Orletskiy, D. O. Timchenko, N. A. Gordeev, Vladislav A. Zharikov, E. S. Kozlova, S. Krylov","doi":"10.17816/vto105227","DOIUrl":null,"url":null,"abstract":"BACKGROUND: Surgical treatment of post-traumatic instability of the shoulder jointinvolves the use of various surgical techniques: open Latarjet procedure, BristowLatarjet operation, which was first performed in Russia at CITO named after N.N. Priorov, the founder of the clinic for sports and ballet trauma, Professor Zoya S. Mironova, also use soft tissue stabilization with anchors, etc. However, in recent years, the Latarjet arthroscopic operation has become a priority choice in the treatment of post-traumatic instability of the shoulder joint. \nAIM: To improve the results and reduce the frequency of postoperative complications, reduce the time of surgical intervention, as well as evaluate the technical difficulties, nuances and improve the surgical technique when performing the arthroscopic Latarjet procedure in professional athletes and amateurs with post-traumatic defects of the shoulder joint. \nMATERIALS AND METHODS: During the period from 2015 to 2021, 50 Latarjet arthroscopic procedure were performed in athletes with post-traumatic defects of the glenoid cavity of the scapula. \nRESULTS: To improve postoperative results, during the Latarjet arthroscopic operation, when positioning the bone autograft, we focused on the 5 oclock in the anterior inferior section of the glenoid cavity of the scapula, which allowed us to maintain the range of motion, namely abduction, flexion and external rotation and bring it almost to the previous level in 96% of patients, the pain syndrome also regressed to 0.80.21 points. Fixation of the capsular-ligamentary apparatus exarticularly allowed to reduce the likelihood of relapse, fracture of the bone autograft, and the development of deforming osteoarthritis of the shoulder joint in the near future. \nCONCLUSIONS: The arthroscopic Latarjet procedure in the treatment of post-traumatic injuries of the shoulder joint is gaining popularity due to the fact that, using low-traumatic approaches, it is possible to correctly position the bone autograft on the anterior-inferior region of the articular surface of the scapula, without subsequent restrictions on the functional component of the shoulder joint.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"23 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"N.N. Priorov Journal of Traumatology and Orthopedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17816/vto105227","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
BACKGROUND: Surgical treatment of post-traumatic instability of the shoulder jointinvolves the use of various surgical techniques: open Latarjet procedure, BristowLatarjet operation, which was first performed in Russia at CITO named after N.N. Priorov, the founder of the clinic for sports and ballet trauma, Professor Zoya S. Mironova, also use soft tissue stabilization with anchors, etc. However, in recent years, the Latarjet arthroscopic operation has become a priority choice in the treatment of post-traumatic instability of the shoulder joint.
AIM: To improve the results and reduce the frequency of postoperative complications, reduce the time of surgical intervention, as well as evaluate the technical difficulties, nuances and improve the surgical technique when performing the arthroscopic Latarjet procedure in professional athletes and amateurs with post-traumatic defects of the shoulder joint.
MATERIALS AND METHODS: During the period from 2015 to 2021, 50 Latarjet arthroscopic procedure were performed in athletes with post-traumatic defects of the glenoid cavity of the scapula.
RESULTS: To improve postoperative results, during the Latarjet arthroscopic operation, when positioning the bone autograft, we focused on the 5 oclock in the anterior inferior section of the glenoid cavity of the scapula, which allowed us to maintain the range of motion, namely abduction, flexion and external rotation and bring it almost to the previous level in 96% of patients, the pain syndrome also regressed to 0.80.21 points. Fixation of the capsular-ligamentary apparatus exarticularly allowed to reduce the likelihood of relapse, fracture of the bone autograft, and the development of deforming osteoarthritis of the shoulder joint in the near future.
CONCLUSIONS: The arthroscopic Latarjet procedure in the treatment of post-traumatic injuries of the shoulder joint is gaining popularity due to the fact that, using low-traumatic approaches, it is possible to correctly position the bone autograft on the anterior-inferior region of the articular surface of the scapula, without subsequent restrictions on the functional component of the shoulder joint.
背景:创伤后肩关节不稳定的手术治疗涉及到各种手术技术的使用:开放式Latarjet手术,BristowLatarjet手术,首次在俄罗斯以运动和芭蕾创伤诊所创始人Zoya S. Mironova教授N.N. Priorov命名的CITO进行,也使用软组织固定锚等。然而,近年来,Latarjet关节镜手术已成为治疗创伤后肩关节不稳的首选方法。目的:提高肩关节创伤后缺损的专业运动员和业余运动员在关节镜下行Latarjet手术的效果,减少术后并发症的发生频率,减少手术干预时间,评估其技术难点和细微差别,改进手术技术。材料和方法:在2015年至2021年期间,对50例肩胛骨盂创伤后缺损的运动员进行了Latarjet关节镜手术。结果:为提高术后效果,在Latarjet关节镜手术中,我们在定位自体骨移植物时,将重点放在肩胛骨盂前下段的5点,96%患者的外展、屈曲、外旋活动范围基本保持在原来的水平,疼痛综合征也恢复到0.0.821点。关节囊-韧带装置的固定可以减少复发、自体骨移植骨折的可能性,以及在不久的将来发生肩关节变形性骨关节炎的可能性。结论:关节镜下Latarjet手术治疗创伤后肩关节损伤越来越受欢迎,因为使用低创伤入路,可以在肩胛骨关节面前下区域正确定位自体骨移植物,而不会对肩关节的功能成分造成限制。