Outcomes of arthroscopic cortical-button Latarjet procedure with minimum 5-year follow-up

IF 2.9 2区医学 Q1 ORTHOPEDICS Journal of Shoulder and Elbow Surgery Pub Date : 2025-05-01 Epub Date: 2024-10-19 DOI:10.1016/j.jse.2024.08.041

Joana Pelletier MD , Hugo Barret MD , Yoann Dalmas MD , Hamza Hamzaoui MD , Pierre Mansat MD, PhD , Nicolas Bonnevialle MD, PhD

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Abstract

Background

The surgical treatment of anterior shoulder instability with arthroscopic cortical-button Latarjet procedure has been the subject of very few medium and long-term studies. The aim of this study was to analyze the clinical and radiologic results of arthroscopic cortical-button Latarjet procedure with minimum 5 years follow-up.

Method

This is a monocentric retrospective study including 40 patients who have undergone shoulder stabilization with primary arthroscopic cortical-button Latarjet procedure and been reviewed with minimum 5 years follow-up. The average age at the time of surgery was 26.6 years (16-59; ±10) and 92.5% were sporty individuals. The average Instability Severity Index score was 6 points (2-9; ±1.6). The clinical evaluation involved active range of motion measurement, apprehension test, Rowe and Walch-Duplay scores, Subjective Shoulder Value and Net Promoter Score. Radiologically, evolution of the bone graft and degenerative arthritis of the shoulder joint were analyzed at the last follow-up.

Results

At an average follow-up of 71 months (60-97; ±12), 3 patients (7.5%) experienced recurrence as a dislocation or subluxation, which was responsible for revision in 1 case. Moreover, apprehension persisted in 6 (16%) patients. There were no significant restrictions in recovery of active ranges of motion, including external rotation. Return to sports was effective in 94.6% of cases. The average Rowe and Walch-Duplay scores were 87 points (15-100; ±20) and 88 points (15-100; ±19) respectively. Subjective Shoulder Value was 91% (10-100; ±16) and NET Promoter Score was 9.3 points (5-10; ±1,3). Radiologically, degenerative arthritis occurred in 18.7% of patients, mainly asymptomatic stage 1 (9.4%). Bone healing was acquired in 72% of cases and partial lysis of the bone block in 41%.

Conclusion

At an average follow-up of 6 years, arthroscopic cortical-button Latarjet procedure is effective, enabling return to sport in 95% of cases. Onset of asymptomatic arthritis seems similar to conventional techniques but justifies a longer-term follow-up.

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关节镜皮质扣式拉塔切口术至少五年随访的结果。

导言：采用关节镜下皮质扣锁Latarjet术治疗肩关节前侧不稳定的中长期研究很少。本研究旨在分析关节镜下皮质扣式Latarjet手术至少5年随访的临床和放射学结果：这是一项单中心回顾性研究，包括40名接受过关节镜下皮质扣式Latarjet肩关节稳定术的患者，并进行了至少5年的随访。手术时的平均年龄为 26.6 岁（16 - 59 岁；± 10 岁），92.5% 的患者喜欢运动。ISI平均分为6分（2-9；±1.6）。临床评估包括活动范围测量、忧虑测试、Rowe 和 Walch-Duplay 评分、SSV 和 Net Promoter Score。在最后一次随访时，对植骨的演变和肩关节退行性关节炎进行了放射学分析：平均随访71个月（60 - 97; ± 12），3名患者（7.5%）复发脱位或半脱位，其中1名患者需要进行翻修。此外，有 6 名患者（16%）持续感到不安。主动活动范围（包括外旋）的恢复没有明显的限制。94.6%的病例能有效恢复运动。Rowe 和 Walch-Duplay 评分的平均值分别为 87 分（15 - 100；± 20）和 88 分（15 - 100；± 19）。SSV 为 91%（10 - 100；± 16），NET Promoter Score 为 9.3 分（5 - 10；± 1.3）。从放射学角度看，18.7%的患者出现了退行性关节炎，主要是无症状的第一阶段（9.4%）。72%的病例骨愈合，41%的病例骨块部分溶解：结论：在平均 6 年的随访中，关节镜下皮质扣锁式 Latarjet 手术疗效显著，95% 的病例可以重返运动场。无症状关节炎的发病似乎与传统技术相似，但需要更长期的随访。

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.