Primary Open Latarjet Procedure Versus Revision to Open Latarjet Procedure for Anterior Shoulder Instability.

IF 1.1 4区医学 Q3 ORTHOPEDICS Orthopedics Pub Date : 2024-09-04 DOI:10.3928/01477447-20240826-06

Rashad Madi, Ryan Lopez, Holt S Cutler, C Lucas Myerson, Alexander Lee, Cody Hansen, David L Glaser, G Russell Huffman, John D Kelly, John G Horneff

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Abstract

Background: Although the Latarjet operation may be performed as a revision surgery for anterior shoulder instability, the high recurrence rate of anterior shoulder instability after arthroscopic Bankart repair (ABR) has led some to advocate for performing the Latarjet procedure as a primary stabilization surgery. The purpose of this study was to compare the intermediate-term outcomes after primary open Latarjet (PLJ) and revision to open Latarjet (RLJ).

Materials and methods: This was a single-institution retrospective analysis of patients who underwent either PLJ or RLJ procedures for anterior shoulder instability between 2014 and 2023. Patients with less than 1 year of follow-up, seizure history, multidirectional instability, concurrent rotator cuff repair, or the absence of preoperative imaging were excluded. Glenoid bone loss (GBL), the width of Hill-Sachs lesions, recurrent dislocations, and reoperations were assessed.

Results: The study included 29 patients, with 12 undergoing PLJ procedures and 17 undergoing RLJ procedures. The mean duration of follow-up was similar for the two groups (4.7 vs 4.6 years, P=.854). Patients undergoing PLJ procedures demonstrated a higher mean GBL (18.4%) compared with patients undergoing revision (10.5%; P=.035); however, there was no significant difference in Hill-Sachs lesion size (14.2 vs 10.4 mm, P=.374). After stratifying according to GBL, the groups undergoing PLJ and RLJ procedures had similar recurrent dislocation rates (8.3% and 11.8%, respectively; P=1.0) and reoperation frequency (25.0% and 23.5%, respectively; P=1.0).

Conclusion: The PLJ and RLJ groups had comparable rates of recurrent dislocations, complications, and reoperations, emphasizing the value of considering Latarjet procedures as revision surgery after unsuccessful primary arthroscopic stabilization. [Orthopedics. 202x;4x(X):xx-xx.].

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肩关节前方失稳的初次开放式 Latarjet 手术与开放式 Latarjet 手术的翻修。

背景：尽管Latarjet手术可作为肩关节前方不稳定的翻修手术，但由于关节镜下Bankart修复术（ABR）后肩关节前方不稳定的复发率较高，因此一些人主张将Latarjet手术作为主要的稳定手术。本研究旨在比较初次开放式Latarjet术（PLJ）和改良开放式Latarjet术（RLJ）的中期疗效：这是一项单一机构的回顾性分析，研究对象是2014年至2023年间因肩前不稳接受PLJ或RLJ手术的患者。随访时间不足1年、有癫痫发作史、多向不稳定性、同时接受肩袖修复术或术前未进行影像学检查的患者被排除在外。对盂骨缺损（GBL）、Hill-Sachs病变宽度、复发性脱位和再次手术进行了评估：研究共纳入29名患者，其中12人接受了PLJ手术，17人接受了RLJ手术。两组患者的平均随访时间相似（4.7 年 vs 4.6 年，P=.854）。接受PLJ手术的患者的平均GBL（18.4%）高于接受翻修手术的患者（10.5%；P=.035）；但Hill-Sachs病变大小（14.2 vs 10.4 mm，P=.374）无显著差异。根据GBL分层后，接受PLJ和RLJ手术组的复发性脱位率（分别为8.3%和11.8%；P=1.0）和再次手术频率（分别为25.0%和23.5%；P=1.0）相似：结论：PLJ组和RLJ组的复发性脱位、并发症和再手术率相当，强调了在初次关节镜稳定手术不成功后将Latarjet手术视为翻修手术的价值。[202x;4x(X):xx-xx]。

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

Orthopedics 医学-整形外科

CiteScore

2.20

自引率

0.00%

发文量

160

审稿时长

3 months

期刊介绍： For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.