Paladini Paolo, Singla Rohit, Merolla Giovanni, Porcellini Giuseppe
Unit of Shoulder and Elbow Surgery-D. Cervesi Hospital, Via L.V. Beethoven 46, Cattolica, RN, Italy.
321/1/19, Medicos Agencies, Opp. Civil Hospital, Rohtak, India.
Int Orthop. 2016 Aug;40(8):1675-1681. doi: 10.1007/s00264-015-3093-z. Epub 2016 Jan 5.
The aim of this study was to establish whether anterior glenoid bone loss in patients with large glenoid rim defects can be restored with a coracoid graft (Latarjet procedure).
A total of 143 consecutive patients with chronic anterior shoulder instability and glenoid bone deficiency were treated in 2013. A pre-operative computed tomography (CT) scan using the PICO method was obtained to estimate anterior glenoid rim erosion. The 23 patients with anterior glenoid deficiency exceeding 20 % were included in the study. A post-operative CT scan was obtained to establish whether coracoid transfer had fully restored the glenoid surface.
Mean bone loss was 26 ± 3.9 % of the glenoid surface (range 20-34 %) compared with the contralateral glenoid. Mean coracoid dimensions were 26.3 ± 2.9 mm × 7.6 ± 0.65 mm. The graft successfully restored the glenoid surface in all patients (mean filling, 102.4 ± 0.8 %).
The Latarjet procedure is a valuable approach to treat patients with chronic shoulder instability and glenoid deficiency.
Coracoid transfer restored the glenoid surface even in patients with large defects. The Eden-Hybinette technique seems to be more appropriate for revision surgery and for patients with a failed Latarjet procedure.
本研究旨在确定对于存在巨大关节盂边缘缺损的患者，喙突移植术（Latarjet手术）能否修复关节盂前部骨质流失。
2013年共治疗了143例连续性慢性肩关节前向不稳和关节盂骨质缺损患者。采用PICO方法进行术前计算机断层扫描（CT）以评估关节盂前部边缘侵蚀情况。纳入研究的23例患者关节盂前部缺损超过20%。术后进行CT扫描以确定喙突转移是否完全修复了关节盂表面。
与对侧关节盂相比，平均骨质流失为关节盂表面的26±3.9%（范围20 - 34%）。喙突平均尺寸为26.3±2.9mm×7.6±0.65mm。移植成功修复了所有患者的关节盂表面（平均填充率，102.4±0.8%）。
Latarjet手术是治疗慢性肩关节不稳和关节盂缺损患者的一种有价值的方法。
即使对于存在巨大缺损的患者，喙突转移也能修复关节盂表面。Eden - Hybinette技术似乎更适合翻修手术以及Latarjet手术失败的患者。
