Department of Orthopaedic Surgery, Istituto Chirurgico Ortopedico Traumatologico (ICOT), Latina, Italy.
Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Istituto Chirurgico Ortopedico Traumatologico (ICOT), Latina, Italy.
Arch Orthop Trauma Surg. 2021 Feb;141(2):189-196. doi: 10.1007/s00402-020-03426-2. Epub 2020 Mar 27.
Different surgical techniques (open and arthroscopic) have been described for the treatment of post-traumatic recurrent anterior instability. The aim of the surgery is to restore when possible, normal shoulder anatomy by repairing the underlying pathology responsible for the instability. Sometimes other surgical techniques are indicated. The purpose of this retrospective study was to investigate the long-term clinical and radiographic results and complications of the open Latarjet procedure after a minimum follow-up of 24 years.
A retrospective study was performed for 67 patients treated with an open Latarjet procedure in a single center. Forty of these 67 patients returned for follow-up evaluation and clinical/radiological examination during the year 2018, having had a minimum of 24-year follow-up. Clinical outcomes were analyzed using two functional scores, in addition to the ROM and strength assessment. Radiographic evaluation included several views (AP views in neutral, internal and external rotation and a comparative Bernageau view) RESULTS: A total of 40 patients underwent an open Latarjet procedure. All the patients were avaible for follow-up at an average of 25.6 years. Clinically, no patient reported any episode of dislocation at the time of follow-up. The mean Rowe score and the Walch-Duplay score were 84.5 (range 45-100) and 83.5 (range 55-100), respectively. Non-union/fibrous union was reported in 12.5% of cases, partial resorption of the graft was found in 7.5% of cases, while total resorption was found in 5% of cases. Osteoarthritis was identified in 52.5% (21) of the patients.
This long-term follow-up study demonstrated that the open Latarjet procedure is a safe and reliable technique for recurrent anterior shoulder instability. The Latarjet procedure provides good long-term stability although associated with a slight limitation in external rotation.
Level III; retrospective cohort comparison; treatment study.
不同的手术技术（开放和关节镜）已被描述用于治疗创伤后复发性前不稳定。手术的目的是通过修复导致不稳定的潜在病理来尽可能恢复正常的肩部解剖结构。有时需要其他手术技术。本回顾性研究的目的是调查开放 Latarjet 手术后至少 24 年的长期临床和影像学结果及并发症。
对单中心接受开放 Latarjet 手术的 67 例患者进行回顾性研究。这 67 例患者中有 40 例在 2018 年接受了随访评估和临床/影像学检查，随访时间至少 24 年。临床结果通过两种功能评分进行分析，此外还评估了 ROM 和力量。影像学评估包括几个视图（中立位、内旋和外旋的 AP 视图以及比较 Bernageau 视图）。
共有 40 例患者接受了开放 Latarjet 手术。所有患者平均随访 25.6 年。临床随访时，所有患者均未报告脱位。平均 Rowe 评分和 Walch-Duplay 评分分别为 84.5（范围 45-100）和 83.5（范围 55-100）。12.5%的病例报告存在不愈合/纤维性愈合，7.5%的病例存在移植物部分吸收，5%的病例存在完全吸收。52.5%（21 例）的患者存在骨关节炎。
这项长期随访研究表明，开放 Latarjet 手术是治疗复发性前肩不稳定的一种安全可靠的技术。Latarjet 手术提供了良好的长期稳定性，但伴有轻微的外旋受限。
三级；回顾性队列比较；治疗研究。
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