iULS-University Institute for Locomotion and Sports, Pasteur 2 Hospital, University Côte d'Azur, Nice, France.
Institut Européen de la Main, HRS Kirchberg, Luxembourg City, Luxembourg.
J Shoulder Elbow Surg. 2019 Nov;28(11):e377-e388. doi: 10.1016/j.jse.2019.03.022. Epub 2019 Jul 19.
To report the results of a guided arthroscopic Eden-Hybbinette procedure, using suture button for iliac crest bone graft fixation, in a series of patients with a prior failed Latarjet and persistent glenoid bone loss.
Seven consecutive patients (5 males, 2 females, mean age: 30.7 years [range, 17-47 years]) with recurrent anterior dislocations and glenoid deficiency greater than 20% underwent the all-arthroscopic revision procedure. The iliac crest bone graft and suture-button device (Bone-Link) were shuttled through the rotator interval. Specific drill guides were used and a suture tensioning device allowed bone graft compression. Previous broken screw shafts (3 patients) were left in situ. Graft placement and healing was assessed postoperatively with computed tomography imaging.
No neurologic injury or hardware problems occurred, and no patient required further surgery. On computed tomography scan, optimal positioning (flush and under the equator) and healing of the bone graft was observed in all patients. At a mean follow-up of 21 months (range, 12-39 months), all but one patient were satisfied and had a stable shoulder; 5 returned to sports. The Constant score increased from 32 to 81 points, and the subjective shoulder value from 31% to 87% (P < .001). The Walch-Duplay and Rowe scores averaged 85.7 (range, 65-100) points and 86.4 (range, 70-100) points, respectively.
Recurrence of anterior shoulder instability after a failed Latarjet procedure can be successfully treated by an all-arthroscopic Eden-Hybbinette procedure. Suture-button fixation is reliable and permits optimal positioning and predictable healing of the new bone graft; in addition, it is an appropriate fixation option in the setting of retained broken hardware.
报告一系列先前 Latarjet 失败且持续存在肩胛盂骨丢失的患者中，使用带线锚钉固定髂嵴骨移植物的关节镜下 Eden-Hybbinette 手术的结果。
7 例连续患者（5 名男性，2 名女性，平均年龄 30.7 岁[范围 17-47 岁]）均为复发性前脱位和肩胛盂缺损大于 20%，接受了全关节镜翻修手术。将髂嵴骨移植物和带线锚钉（Bone-Link）穿过肩袖间隙。使用特定的钻头导向器，并使用缝线张力器使骨移植物压缩。先前的断钉（3 例）仍保留在原位。术后通过计算机断层扫描评估植骨的位置和愈合情况。
无神经损伤或硬件问题发生，无患者需要进一步手术。在计算机断层扫描上，所有患者均观察到骨移植物的最佳位置（平齐和位于赤道下）和愈合。平均随访 21 个月（范围 12-39 个月），除 1 例外，所有患者均满意且肩部稳定；5 例恢复运动。Constant 评分从 32 分增加到 81 分，主观肩部评分从 31%增加到 87%（P<.001）。Walch-Duplay 和 Rowe 评分平均为 85.7（范围 65-100）分和 86.4（范围 70-100）分。
Latarjet 手术失败后复发性前肩不稳可通过全关节镜下 Eden-Hybbinette 手术成功治疗。带线锚钉固定可靠，可实现新骨移植物的最佳定位和可预测的愈合；此外，在保留断钉的情况下，它是一种合适的固定选择。
