Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Argentina.
Am J Sports Med. 2020 Jul;48(9):2081-2089. doi: 10.1177/0363546520928343. Epub 2020 Jun 16.
There is a lack of evidence in the literature comparing outcomes between the classic and the congruent arc Latarjet procedures in athletes.
To compare return to sports, functional outcomes, and complications between the classic and the congruent arc Latarjet procedures in athletes with recurrent glenohumeral instability.
Cohort study; Level of evidence, 3.
Between June 2009 and June 2017, 145 athletes with recurrent anterior glenohumeral instability underwent surgery with the Latarjet as a primary procedure in our institution. The classic procedure was used in 66 patients, and the congruent arc method was used in 79 patients. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sports activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography.
In the total population, the mean follow-up was 41.3 months (range, 24-90 months) and the mean age was 25.3 years (range, 18-45 years). In total, 90% of patients were able to return to sports; of these, 91% returned at their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistical improvement after operation ( .001). The Rowe score increased from a preoperative mean of 42.8 points to a postoperative mean of 95.2 points ( < .01). Subjective pain during sports improved from 3.2 points preoperatively to 0.7 points at last follow-up ( < .01). The ASOSS score improved significantly from a preoperative mean of 46.4 points to a postoperative mean of 88.4 points ( < .01). No significant differences in shoulder ROM and functional scores were found between patients who received the classic vs congruent arc procedures. There were 5 recurrences (3.5%): 3 dislocations (2%) and 2 subluxations (1%). No significant difference in the recurrence rate was noted between groups. The bone block healed in 134 cases (92%).
In athletes with recurrent anterior glenohumeral instability, the Latarjet procedure produced excellent functional outcomes. Most athletes returned to sports at their preinjury level, and the rate of recurrence was very low, regardless of whether the patients received surgery with the classic or congruent arc technique.
在文献中，比较经典和一致弧形 Latarjet 手术治疗复发性肩盂前不稳定运动员的结果缺乏证据。
比较经典和一致弧形 Latarjet 手术治疗复发性肩盂前不稳定运动员的重返运动、功能结果和并发症。
队列研究；证据水平，3 级。
2009 年 6 月至 2017 年 6 月，我院收治了 145 例复发性前肩盂不稳定的运动员，采用 Latarjet 作为原发性手术。66 例患者采用经典手术，79 例患者采用一致弧形方法。采用重返运动、运动范围（ROM）、Rowe 评分、运动时疼痛视觉模拟评分（VAS）和运动肩结局评分系统（ASOSS）评估功能结果。还评估了复发情况。术后使用计算机断层扫描评估骨块位置和骨融合情况。
在总人群中，平均随访时间为 41.3 个月（范围 24-90 个月），平均年龄为 25.3 岁（范围 18-45 岁）。共有 90%的患者能够重返运动，其中 91%的患者恢复到受伤前的运动水平。术前和术后的肩部 ROM 无显著差异。Rowe、VAS 和 ASOSS 评分术后均有统计学改善（<.001）。Rowe 评分从术前的 42.8 分增加到术后的 95.2 分（<.01）。主观运动疼痛从术前的 3.2 分降至末次随访时的 0.7 分（<.01）。ASOSS 评分从术前的 46.4 分显著提高到术后的 88.4 分（<.01）。经典组与一致弧形组患者的肩部 ROM 和功能评分无显著差异。有 5 例复发（3.5%）：3 例脱位（2%），2 例半脱位（1%）。两组间复发率无显著差异。134 例（92%）骨块愈合。
对于复发性前肩盂不稳定的运动员，Latarjet 手术可获得良好的功能结果。大多数运动员能够恢复到受伤前的运动水平，且复发率非常低，无论患者采用经典或一致弧形技术手术。
