Hatta Taku, Yamamoto Nobuyuki, Shinagawa Kiyotsugu, Kawakami Jun, Itoi Eiji
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.
JSES Open Access. 2019 Mar 9;3(1):25-28. doi: 10.1016/j.jses.2018.10.001. eCollection 2019 Mar.
The purpose of this study was to assess the clinical outcomes of patients with anterior shoulder instability who underwent surgical treatment according to the on-track/off-track concept.
We retrospectively analyzed patients who underwent surgical treatment according to the glenoid track concept with a minimum of 2 years' follow-up. By use of preoperative 3-dimensional computed tomography images, surgical options were selected: arthroscopic Bankart repair (ABR) for patients with on-track lesions and the Latarjet procedure or ABR with the remplissage procedure for patients with off-track lesions. The recurrence rate was assessed at 2-year follow-up after surgery.
Among 92 patients enrolled in this study, 81 had on-track lesions and underwent ABR. Of the 11 patients with off-track lesions, 1 underwent ABR with the remplissage procedure and 10 underwent the Latarjet procedure. Recurrences occurred in 4 patients treated by ABR (5%), whereas no recurrences were observed in off-track cases treated by the remplissage or Latarjet procedure.
Clinical application of the on-track/off-track concept for determining surgical options in preoperative planning seems to be useful to prevent recurrent instability after surgery.
本研究旨在评估根据轨道内/轨道外概念接受手术治疗的前肩不稳患者的临床疗效。
我们回顾性分析了根据关节盂轨道概念接受手术治疗且随访至少2年的患者。通过术前三维计算机断层扫描图像，选择手术方案：轨道内损伤患者行关节镜下Bankart修复术（ABR），轨道外损伤患者行Latarjet手术或ABR联合 remplissage手术。术后2年随访时评估复发率。
本研究纳入的92例患者中，81例有轨道内损伤并接受了ABR。11例轨道外损伤患者中，1例行ABR联合remplissage手术，10例行Latarjet手术。ABR治疗的4例患者出现复发（5%），而remplissage或Latarjet手术治疗的轨道外病例未观察到复发。
在术前规划中应用轨道内/轨道外概念来确定手术方案的临床应用似乎有助于预防术后复发性不稳。
