Département d'Orthopédie Traumatologie du Centre Hospitalier Universitaire de Toulouse, Hôpital Riquet, Toulouse, France; Laboratoire de Biomécanique, Institut de Mécanique des Fluides de Toulouse- Unité Mixte de Recherche-Le Centre national de la recherche scientifique 5502, Hôpital Riquet, Toulouse, France.
Clinique du Sport et de Chirurgie Orthopédique, Marcq-en-Barœul, France.
J Shoulder Elbow Surg. 2018 Jun;27(6):e189-e195. doi: 10.1016/j.jse.2017.12.007. Epub 2018 Jan 12.
The arthroscopic Latarjet with double-button fixation is a guided procedure recently proposed to treat anterior shoulder instability with glenoid bone loss. The goal of this study was to report intraoperative and early postoperative complications and to analyze the learning curve.
This was a prospective, nonrandomized study that included 88 patients. Intraoperative or postoperative complications as well as adverse events and operative time were recorded. Clinical outcomes were evaluated at 2 weeks, 1.5 months, and at the last follow-up. Radiologic analysis was based on an immediate postoperative computed tomography scan.
The intraoperative complications or adverse events rate was 3.3%: 1 conversion to open surgery, 1 bone block fracture, and 1 instrumentation problem. The postoperative complication rate was 6.8%: 4 coracoid migrations, and 2 subluxations. None of these complications occurred beyond the 10th case performed. The average operative time significantly decreased with surgical experience (r = -0.8426; 95% confidence interval, -0.9074 to -0.7384; P < .0001) to reach 76 ± 12 minutes (range, 62-95 minutes) at 30 cases. Radiologically, 90% of the bone blocks were flush and subequatorial beyond the 30th case. At a mean follow-up of 12.6 months (range, 6-24 months), Walch-Duplay and Rowe scores were 80 and 81 points, respectively.
At short-term follow-up, the arthroscopic Latarjet procedure with double-button fixation exhibited a low complication rate. Operative time significantly improved with surgical experience and was optimized after 30 cases. Early clinical results confirmed that this procedure can be safe and reliable.
关节镜下双纽扣固定 Latarjet 术是一种最近提出的治疗伴有肩胛盂骨缺损的肩关节前向不稳定的引导性手术。本研究的目的是报告术中及术后早期并发症，并分析学习曲线。
这是一项前瞻性、非随机研究，共纳入 88 例患者。记录术中或术后并发症、不良事件及手术时间。术后 2 周、1.5 个月及末次随访时进行临床评估。影像学分析基于术后即刻 CT 扫描。
术中并发症或不良事件发生率为 3.3%：1 例转为开放手术，1 例骨块骨折，1 例器械相关问题。术后并发症发生率为 6.8%：4 例喙突迁移，2 例半脱位。这些并发症均未发生在第 10 例之后。随着手术经验的增加，手术时间显著缩短（r=-0.8426；95%置信区间：-0.9074 至-0.7384；P<.0001），在第 30 例时达到 76±12 分钟（范围：62-95 分钟）。影像学上，第 30 例之后，90%的骨块平齐且位于肩胛盂下。平均随访 12.6 个月（范围：6-24 个月）时，Walch-Duplay 和 Rowe 评分分别为 80 分和 81 分。
短期随访时，关节镜下双纽扣固定 Latarjet 术并发症发生率较低。手术时间随着手术经验的增加而显著改善，在第 30 例后优化。早期临床结果证实该手术安全可靠。
Zotero 插件