Kleiner Matthew T, Payne William B, McGarry Michelle H, Tibone James E, Lee Thay Q
Department of Orthopaedic Surgery, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System, Long Beach, CA, USA.
Clin Orthop Surg. 2016 Mar;8(1):84-91. doi: 10.4055/cios.2016.8.1.84. Epub 2016 Feb 13.
The purpose of this study was to determine if capsular repair used in conjunction with the Latarjet procedure results in significant alterations in glenohumeral rotational range of motion and translation.
Glenohumeral rotational range of motion and translation were measured in eight cadaveric shoulders in 90° of abduction in both the scapular and coronal planes under the following four conditions: intact glenoid, 20% bony Bankart lesion, modified Latarjet without capsular repair, and modified Latarjet with capsular repair.
Creation of a 20% bony Bankart lesion led to significant increases in anterior and inferior glenohumeral translation and rotational range of motion (p < 0.005). The Latarjet procedure restored anterior and inferior stability compared to the bony Bankart condition. It also led to significant increases in glenohumeral internal and external rotational range of motion relative to both the intact and bony Bankart conditions (p < 0.05). The capsular repair from the coracoacromial ligament stump to the native capsule did not significantly affect translations relative to the Latarjet condition; however it did cause a significant decrease in external rotation in both the scapular and coronal planes (p < 0.005).
The Latarjet procedure is effective in restoring anteroinferior glenohumeral stability. The addition of a capsular repair does not result in significant added stability; however, it does appear to have the effect of restricting glenohumeral external rotational range of motion relative to the Latarjet procedure performed without capsular repair.
本研究的目的是确定在Latarjet手术中联合使用关节囊修复是否会导致盂肱关节旋转活动范围和平移发生显著改变。
在以下四种情况下，于尸体肩关节外展90°时，在肩胛平面和冠状平面测量盂肱关节的旋转活动范围和平移：关节盂完整、20%的骨性Bankart损伤、未进行关节囊修复的改良Latarjet手术、进行了关节囊修复的改良Latarjet手术。
造成20%的骨性Bankart损伤导致盂肱关节前向和下向平移以及旋转活动范围显著增加（p < 0.005）。与骨性Bankart损伤情况相比，Latarjet手术恢复了前向和下向稳定性。相对于关节盂完整和骨性Bankart损伤情况，它还导致盂肱关节内旋和外旋活动范围显著增加（p < 0.05）。从喙肩韧带残端至天然关节囊的关节囊修复相对于Latarjet手术情况并未显著影响平移；然而，它确实导致肩胛平面和冠状平面的外旋显著减少（p < 0.005）。
Latarjet手术在恢复盂肱关节前下稳定性方面是有效的。增加关节囊修复并不会带来显著的额外稳定性；然而，相对于未进行关节囊修复的Latarjet手术，它似乎确实具有限制盂肱关节外旋活动范围的作用。
