IF 2.9 2区 医学 Q1 ORTHOPEDICS Journal of Shoulder and Elbow Surgery Pub Date : 2025-02-13 DOI:10.1016/j.jse.2024.12.046
Isabelle Rogowski, Laurent Nové-Josserand, Arnaud Godenèche, Philippe Collotte, Gabriel Franger, Florent Borel, Grégory Vigne, Thais Dutra Vieira, Yoann Blache, Lionel Neyton
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引用次数: 0

摘要

背景:目前还没有证据表明,开放式Latarjet手术后,必须恢复到哪种功能水平才能恢复到受伤前的运动水平,即成功的RTS。因此,本研究旨在确定术后 4.5 个月评估的 RTS 标准能否预测开放式 Latarjet 术后 1 年的成功 RTS:所有在2018年8月至2021年7月期间接受开放式Latarjet手术的患者均符合条件。术后4.5个月时,患者填写肩关节不稳定性-伤后恢复运动问卷,并进行单侧每侧最大等长盂肱内旋和外旋力量、上肢Y平衡测试、单侧坐位推铅球测试和改良闭合动能链上肢稳定性测试。他们在术后 12 个月回答了 RTS 问卷。应用逻辑回归评估基于手术-非手术比率或优势-非优势比率预测成功RTS的能力:在126名符合条件的患者中,110人回答了RTS询问;21人被排除在外,49人被纳入RTS成功组,40人被纳入RTS失败组。基于手术-非手术比例的比率都不是成功 RTS 的预后因素。尽管模型的精确度较低(ROC曲线下面积=0.64),但内旋力量的优势-非优势比(奇数比=0.98;P=0.02)、手术肩部外旋和内旋力量的平衡(OR=1.03;P=0.02)和肌肉耐力能力(OR=1.03;P=0.04)被认为是成功RTS的预后因素:研究结果对参照手术肩部功能和对侧肩部功能的标准来预测成功重返运动场的能力提出了质疑。研究结果表明,在术后 4.5 个月进行评估时,以健康运动员的肩部功能为参照,对优势肩部和非优势肩部的功能平衡进行评估,可以更好地预测运动员能否恢复到受伤前的运动水平。这项研究强调,临床医生和运动指导员应特别关注最大内旋力量和上肢力量耐力的优势-非优势平衡恢复情况,以提高通过开放式拉塔杰特手术进行肩关节前部稳定手术的运动员成功重返运动场的可能性。
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Are the dominant-nondominant functional differences at 4.5 months after open Latarjet procedure better predictors for successful return-to-sport at 1-year postoperatively than the operated-nonoperated differences?

Background: There is no evidence on which functional levels have to be recovered to return to the preinjury sport at preinjury level, i.e. successful RTS, after open Latarjet procedure. Therefore, this study aimed to identify whether RTS criteria assessed at 4.5 months postoperatively predict successful RTS at 1 year after open Latarjet procedure.

Methods: All patients who underwent an open Latarjet procedure between August 2018 and July 2021 were eligible. At 4.5 months postoperatively, patients completed the Shoulder Instability-Return to Sport after Injury questionnaire, and performed unilaterally with each side maximal isometric strength in glenohumeral internal and external rotation, upper-quarter Y balance test, unilateral seated shot-put test, and modified closed kinetic chain upper extremity stability test. They answered RTS inquiry at 12 months postoperatively. Logistic regressions were applied to assess the ability of ratios based on operated-nonoperated ratios, or on dominant-nondominant ratios, to predict successful RTS.

Results: Among 126 eligible patients, 110 answered the RTS inquiry; 21 were excluded, 49 patients were included in the successful RTS group, and 40 in the unsuccessful RTS. No ratios based on operated-nonoperated ratios were prognostic factors for successful RTS. Despite a low precision of the model (area under the ROC curve = 0.64), dominant-nondominant ratios in internal rotation strength (Odd-Ratio = 0.98; p=0.02), balance between external and internal rotator strength at the operated shoulder (OR = 1.03; p=0.02) and muscular endurance ability (OR = 1.03; p=0.04) were found prognostic factors for successful RTS.

Conclusion: The findings challenge the ability of criteria expressing operated shoulder functions with reference to those of the contralateral one in predicting a successful return to sport. They suggest that, when assessed 4.5 months postoperatively, the balance of function between dominant and nondominant shoulders in reference to those of healthy athletes would be better predictors of returning to preinjury sport at the preinjury level. This study highlights that clinicians and sport supervisors may place particular care on recovery in dominant-nondominant balance in maximal internal rotation strength and in upper extremities strength endurance to enhance the likelihood to return to sport successfully for their athletes who underwent anterior shoulder stabilization surgery by open Latarjet procedure.

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来源期刊
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.
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