Prinja Aditya, Raymond Antony, Pimple Mahesh
Whipps Cross University Hospital, London, UK.
Adv Orthop. 2020 Jan 24;2020:7496492. doi: 10.1155/2020/7496492. eCollection 2020.
Traumatic anterior instability of the shoulder is commonly treated with the Latarjet procedure, which involves transfer of the coracoid process with a conjoint tendon to the anterior aspect of the glenoid. The two most common techniques of the Latarjet are the classical and congruent arc techniques. The aim of this study was to evaluate the difference in force required to dislocate the shoulder after classical and congruent arc Latarjet procedures were performed. Fourteen cadaveric shoulders were dissected and osteotomised to produce a bony Bankart lesion of 25% of the articular surface leading to an "inverted pear-shaped" glenoid. An anteroinferior force was applied whilst the arm was in abduction and external rotation using a pulley system. The force needed to dislocate was noted, and then the shoulders underwent coracoid transfer with the classical and congruent arc techniques. The average force required to dislocate the shoulder after osteotomy was 123.57 N. After classical Latarjet, the average force required was 325.71 N, compared with 327.14 N after the congruent arc technique. This was not statistically significant. In this biomechanical cadaveric study, there is no difference in the force required to dislocate a shoulder after classical and congruent arc techniques of Latarjet, suggesting that both methods are equally effective at preventing anterior dislocation in the position of abduction and external rotation.
创伤性肩关节前不稳定通常采用拉塔热（Latarjet）手术治疗，该手术包括将喙突与联合腱转移至肩胛盂的前侧。拉塔热手术最常用的两种技术是经典技术和全等弧技术。本研究的目的是评估在实施经典拉塔热手术和全等弧拉塔热手术后，使肩关节脱位所需力量的差异。对14具尸体肩关节进行解剖和截骨，造成占关节面25%的骨性Bankart损伤，导致肩胛盂呈“倒梨形”。使用滑轮系统在手臂外展和外旋时施加前下方向的力。记录脱位所需的力，然后分别采用经典技术和全等弧技术对肩关节进行喙突转移。截骨术后使肩关节脱位所需的平均力为123.57N。经典拉塔热手术后，所需的平均力为325.71N，全等弧技术术后为327.14N。二者无统计学差异。在这项生物力学尸体研究中，经典拉塔热技术和全等弧拉塔热技术术后使肩关节脱位所需的力没有差异，这表明两种方法在防止外展和外旋位的前脱位方面同样有效。
