Cleveland Clinic Sports Health Center, Garfield Heights, OH 44125, USA.
J Shoulder Elbow Surg. 2013 Feb;22(2):286-92. doi: 10.1016/j.jse.2012.09.009.
Various methods of bony stabilization, including modifications of Bristow and Latarjet procedures, are considered gold-standard treatment for recurrent anterior shoulder instability but are associated with unique complications and risk of reoperation. The purpose of this study was to identify the prevalence of these complications. We hypothesized that the Bristow-Latarjet procedure would be a successful technique for treatment of shoulder instability but associated with a risk of recurrent postoperative instability, reoperation, and other complications.
A systematic review of multiple medical databases included studies reporting outcomes with complication and reoperation rates following original or modified versions of the Bristow or Latarjet shoulder stabilization surgeries.
Forty-five studies were analyzed (1,904 shoulders) (all Level IV evidence). Most subjects were male (82%). The dominant shoulder was the operative shoulder in 64% of cases. Mean subject age was 25.8 years. Mean clinical follow-up was 6.8 years. Ninety percent of surgeries were done open; 9.3% were all-arthroscopic. Total complication rate was 30%. Recurrent anterior dislocation and subluxation rates were 2.9% and 5.8%, respectively. When reported, most dislocations occurred within the first year postoperatively (73%). Nearly 7% of patients required an unplanned reoperation following surgery.
Osseous stabilization shoulder surgery using original or modified Bristow and Latarjet procedures has a 30% complication rate. Rates of recurrent dislocation and reoperation were 2.9% and 7%, respectively. Mild loss of external rotation is common. Reoperation rates were lower following all-arthroscopic techniques. There was a greater loss of postoperative external rotation with all-arthroscopic surgery.
各种骨固定方法，包括 Bristow 和 Latarjet 手术的改良，被认为是复发性肩关节前不稳定的金标准治疗方法，但与独特的并发症和再次手术的风险相关。本研究的目的是确定这些并发症的发生率。我们假设 Bristow-Latarjet 手术将是治疗肩关节不稳定的成功技术，但存在术后再发性不稳定、再次手术和其他并发症的风险。
对多个医学数据库进行系统回顾，包括报告原始或改良版 Bristow 或 Latarjet 肩部稳定手术后并发症和再手术率的研究。
分析了 45 项研究（1904 肩）（均为 IV 级证据）。大多数患者为男性（82%）。优势肩为手术肩的占 64%。平均患者年龄为 25.8 岁。平均临床随访 6.8 年。90%的手术为开放式；9.3%为全关节镜下。总并发症发生率为 30%。复发性前脱位和半脱位的发生率分别为 2.9%和 5.8%。当报告时，大多数脱位发生在术后第一年（73%）。近 7%的患者在手术后需要计划外再次手术。
使用原始或改良 Bristow 和 Latarjet 手术进行的骨稳定肩部手术有 30%的并发症发生率。复发性脱位和再次手术的发生率分别为 2.9%和 7%。轻度外旋丧失较为常见。全关节镜技术后再次手术率较低。全关节镜手术后术后外旋丧失较多。
