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布里斯托-拉塔热手术对运动员进行肩关节前路稳定术:至少2年随访的重返运动和功能结果

Anterior shoulder stabilization by Bristow-Latarjet procedure in athletes: return-to-sport and functional outcomes at minimum 2-year follow-up.

作者信息

Beranger Jean Sébastien, Klouche Shahnaz, Bauer Thomas, Demoures Thomas, Hardy Philippe

机构信息

Hôpitaux universitaires Paris Île-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France.

Ambroise Paré Hospital, 9, avenue Charles De Gaulle, 92104, Boulogne-Billancourt, France.

出版信息

Eur J Orthop Surg Traumatol. 2016 Apr;26(3):277-82. doi: 10.1007/s00590-016-1751-5. Epub 2016 Mar 1.

Abstract

PURPOSE

The aim of this study was to assess return-to-sport outcomes following the Latarjet-Bristow procedure.

METHODS

This retrospective study included all athletes <50 years old, who underwent a Latarjet-Bristow procedure for anterior shoulder instability in 2009-2012. Main criteria assessments were the number of athletes returning to any sport and the number returning to the same sport at their preinjury level. The main follow-up was 46.8 ± 9.7 months.

RESULTS

Forty-seven patients were analyzed, 46 men/1 women, mean age 27.9 ± 7.9 years. Eighteen patients practiced competitive sports and 29 recreational sports. None of them were professional athletes. One hundred percent returned to sports after a mean 6.3 ± 4.3 months. Thirty/47 (63.8 %) patients returned to the same sport at the same level at least and 10/47 (21.3 %) patients changed sport because of their shoulder. Compared to patients who returned to the same sport at the same level, patients who changed sports or returned to a lower level had practiced overhead or forced overhead sports [OR = 4.7 (1.3-16.9), p = 0.02] before surgery, experienced avoidance behavior at the final follow-up (p = 0.002), apprehension (p = 0.00001) and had a worse Western Ontario Shoulder Instability Index score and sub-items (p = 0.003) except for daily activities (p = 0.21). At the final follow-up, 45/47 (95.7 %) patients were still practicing a sport.

CONCLUSION

All the patients returned to sports, most to their preinjury sport at the same level. Patients who practiced an overhead sport were more likely to play at a lower level or to change sport postoperatively.

LEVEL OF EVIDENCE

IV, retrospective study-Case series with no comparison group.

摘要

目的

本研究旨在评估Latarjet-Bristow手术后的运动恢复情况。

方法

这项回顾性研究纳入了2009年至2012年间所有年龄小于50岁、因前肩不稳接受Latarjet-Bristow手术的运动员。主要评估标准是恢复任何运动的运动员人数以及恢复到受伤前水平的同一项运动的运动员人数。主要随访时间为46.8±9.7个月。

结果

分析了47例患者,其中46例男性/1例女性,平均年龄27.9±7.9岁。18例患者从事竞技运动,29例从事休闲运动。他们均非职业运动员。平均6.3±4.3个月后,所有患者均恢复运动。47例患者中有30例(63.8%)至少恢复到相同水平的同一项运动,10例(21.3%)患者因肩部问题更换了运动项目。与恢复到相同水平的同一项运动的患者相比,更换运动项目或恢复到较低水平的患者术前从事过头顶或强迫性头顶运动[比值比=4.7(1.3-16.9),p=0.02],在末次随访时出现回避行为(p=0.002)、恐惧(p=0.00001),除日常活动外(p=0.21),西安大略肩不稳指数评分及各子项更差(p=0.003)。在末次随访时,47例患者中有45例(95.7%)仍在进行一项运动。

结论

所有患者均恢复运动,大多数恢复到受伤前相同水平的运动项目。从事头顶运动的患者术后更有可能以较低水平进行运动或更换运动项目。

证据水平

IV级,回顾性研究——无对照组的病例系列研究。

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