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肩锁关节前向不稳定 Latarjet 手术的长期疗效:10 年随访的系统评价研究。

Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies at 10-year follow-up.

机构信息

Sports Surgery Clinic, Dublin, Ireland; Department of Trauma & Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.

Sports Surgery Clinic, Dublin, Ireland; Department of Trauma & Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

J Shoulder Elbow Surg. 2019 Feb;28(2):e33-e39. doi: 10.1016/j.jse.2018.08.028. Epub 2018 Dec 11.

Abstract

BACKGROUND

This study systematically reviewed the evidence in the literature to ascertain the functional outcomes, recurrences rates, and subsequent revision rates after the open Latarjet procedure at a minimum of 10 years of follow-up.

METHODS

Two independent reviewers performed the literature search based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the Embase, MEDLINE, and The Cochrane Library Databases. Studies that reported a minimum of 10 years of clinical follow-up after the Latarjet procedure were included.

RESULTS

Our review found 13 studies including 822 patients (845 shoulders) meeting our inclusion criteria. Patients (82% men) were an average age of 27.4 years, and mean follow-up was 199.2 months (16.6 years). The commonly used functional outcome score was the Rowe score with a weighted mean average of 88.5. The overall rate of return to play sports was 84.9%, with 76.3% returning to the same level of play. The rate of good/excellent outcomes was 86.1%. The recurrent instability rate was 8.5%, with 3.2% of patients having recurrent dislocations. The revision rate was 3.7%, with 1.6% of patients undergoing revisions due to recurrence. There were arthritic changes in 38.2% of patients and residual shoulder pain in 35.7%, with 4.8% experiencing daily pain.

CONCLUSIONS

The Latarjet procedure for anterior shoulder instability results in excellent functional outcomes at long-term and a high rate of return to sport among athletes. However, varying rates of recurrence, residual pain, and progression of instability arthropathy are still of concern.

摘要

背景

本研究系统地回顾了文献中的证据,以确定开放式 Latarjet 手术后至少 10 年随访时的功能结果、复发率和随后的翻修率。

方法

两名独立的审查员根据系统评价和荟萃分析的首选报告项目指南进行文献检索,使用 Embase、MEDLINE 和 The Cochrane Library 数据库。纳入报告 Latarjet 手术后至少 10 年临床随访的研究。

结果

我们的综述发现了 13 项研究,包括符合纳入标准的 822 例患者(845 例肩)。患者(82%为男性)的平均年龄为 27.4 岁,平均随访时间为 199.2 个月(16.6 年)。常用的功能结果评分是 Rowe 评分,加权平均为 88.5。重返运动的总体比例为 84.9%,其中 76.3%恢复到相同的运动水平。良好/优秀结果的比例为 86.1%。复发性不稳定的发生率为 8.5%,其中 3.2%的患者出现复发性脱位。翻修率为 3.7%,其中 1.6%的患者因复发而接受翻修。38.2%的患者有骨关节炎变化,35.7%的患者有残留肩部疼痛,4.8%的患者有日常疼痛。

结论

对于前肩不稳定,Latarjet 手术可获得长期的优异功能结果,并使运动员有很高的重返运动的比例。然而,复发率、残留疼痛和不稳定关节炎进展的差异仍然令人担忧。

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