Department of Sports Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China.
Am J Sports Med. 2020 Jan;48(1):39-47. doi: 10.1177/0363546519887959. Epub 2019 Nov 25.
Some studies have advocated the use of suture-button fixation during the Latarjet procedure to reduce complications associated with screw fixation. However, the sample size of these studies is relatively small, and their follow-up period is short.
To investigate the efficacy of the suture-button Latarjet procedure with at least 3 years of follow-up and remodeling of the coracoid graft.
Case series; Level of evidence, 4.
A total of 152 patients who underwent the suture-button Latarjet procedure between February 2013 and February 2016 were selected, and 128 patients who met the inclusion criteria were enrolled in this study. Preoperative and postoperative clinical results were assessed. The position and healing condition of the coracoid graft and arthropathy of the glenoid and humeral head were also assessed using radiography and 3-dimensional computed tomography (CT).
The mean follow-up time was 40.3 ± 5.8 months. There were 102 patients included in this study. The mean visual analog scale score for pain during motion, the American Shoulder and Elbow Surgeons score, the Rowe score, and the Walch-Duplay score were improved considerably. A total of 100 grafts achieved bone union. The overall absorption rate was 12.6% ± 4.3%. Graft absorption mostly occurred on the edge and outside the "best-fit" circle of the glenoid. A vertical position was achieved in 98 grafts (96% of all cases) immediately postoperatively, with the mean graft midline center at the 4 o'clock position. In the axial view, CT showed that 89 grafts were flush to the glenoid, whereas 2 and 11 grafts were fixed medially and laterally, respectively. In all cases, the bone graft and glenoid tended to extend toward each other to form concentric circles during the remodeling process. During follow-up observations, the height of the 11 grafts that were positioned laterally (ie, above the glenoid level) exhibited a wave-curved change. No arthropathy was observed in any patient.
Patient outcomes were satisfactory after the modified arthroscopic suture-button Latarjet technique. Graft absorption mostly occurred on the edge and outside the "best-fit" circle of the glenoid. The graft exhibited the phenomenon of ectatic growing when it fused with the glenoid and finally remodeled to a new concentric circle with the humeral head analogous to the original glenoid. Grafts positioned laterally did not cause arthropathy of the joints within the period of the study.
一些研究主张在 Latarjet 手术中使用缝线纽扣固定以减少与螺钉固定相关的并发症。然而，这些研究的样本量相对较小，随访时间较短。
探讨至少 3 年随访和喙突移植物重塑的缝线纽扣 Latarjet 手术的疗效。
病例系列；证据水平，4 级。
选择 2013 年 2 月至 2016 年 2 月期间行缝线纽扣 Latarjet 手术的 152 例患者，纳入符合纳入标准的 128 例患者进行研究。评估术前和术后的临床结果。使用 X 线和 3 维 CT 评估喙突移植物的位置和愈合情况以及肩胛盂和肱骨头的关节炎。
平均随访时间为 40.3 ± 5.8 个月。本研究共纳入 102 例患者。运动时疼痛的视觉模拟评分、美国肩肘外科医生评分、Rowe 评分和 Walch-Duplay 评分均显著改善。100 个移植物全部获得骨性愈合。总体吸收率为 12.6%±4.3%。移植物吸收主要发生在肩胛盂“最佳拟合”圆的边缘和外部。术后即刻 98 个移植物（所有病例的 96%）达到垂直位置，移植物中线中心平均位于 4 点钟位置。在轴位视图中，CT 显示 89 个移植物与肩胛盂平齐，而 2 个和 11 个移植物分别固定在内侧和外侧。在所有病例中，在重塑过程中，骨移植物和肩胛盂趋于相互靠近形成同心圆。在随访观察期间，位于外侧（即高于肩胛盂水平）的 11 个移植物的高度表现出波浪状变化。在任何患者中均未观察到关节炎。
改良关节镜缝线纽扣 Latarjet 技术后患者的预后满意。移植物吸收主要发生在肩胛盂“最佳拟合”圆的边缘和外部。移植物与肩胛盂融合后呈现扩张生长现象，最终重塑为与肱骨头新的同心圆，类似于原始肩胛盂。在研究期间，位于外侧的移植物未引起关节关节炎。
