用于治疗前盂肱关节不稳的Latarjet手术：初次喙突转移与既往稳定手术失败后翻修喙突转移的术后早期并发症
Latarjet Procedure for Anterior Glenohumeral Instability: Early Postsurgical Complications for Primary Coracoid Transfer Versus Revision Coracoid Transfer After Failed Prior Stabilization.
作者信息
Updegrove Gary F, Buckley Patrick S, Cox Ryan M, Selverian Stephen, Patel Manan S, Abboud Joseph A
机构信息
Department of Orthopaedics and Rehabilitation, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
出版信息
Orthop J Sports Med. 2020 Jun 12;8(6):2325967120924628. doi: 10.1177/2325967120924628. eCollection 2020 Jun.
BACKGROUND
The Latarjet procedure (coracoid transfer) is often used to successfully treat failed instability procedures. However, given the reported increased complication rates in primary Latarjet surgery, there is a heightened concern for complications in performing the Latarjet procedure as revision surgery.
PURPOSE
To evaluate the early outcomes and complications of the Latarjet procedure as primary surgery compared with revision surgery.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
A total of 157 patients were included and retrospectively reviewed: 103 patients in the revision group and 54 patients in the primary group. Patients were evaluated by physical examination findings as well as by documentation of complications and reoperations extracted from their electronic medical records.
RESULTS
The mean follow-up was 7.8 ± 11.0 months for the primary group and 7.0 ± 13.2 months for the revision group. There were no significant differences in overall complication rates between the primary and revision groups (16.7% vs 8.7%, respectively; = .139). The complication rate was significantly higher in patients in the revision group who had undergone a prior open procedure compared with those who had undergone only arthroscopic procedures (30.0% vs 4.1%, respectively; < .001). Of those patients who sustained a complication, 7 of the 9 underwent a reoperation in the primary group (13.0%), and 7 of the 9 did so in the revision group (6.8%); the risk of reoperations was not different between groups ( = .198). There were 4 patients in the primary group (7.4%) and 5 patients in the revision group (4.9%) who experienced recurrent dislocations during the follow-up period ( = .513). There was no difference in postoperative range of motion.
CONCLUSION
The Latarjet procedure is a reasonable option for the treatment of failed arthroscopic instability repair with an early complication rate similar to that found in primary Latarjet surgery.
背景
拉塔热手术（喙突转移术）常用于成功治疗失败的不稳定手术。然而，鉴于报道的初次拉塔热手术并发症发生率增加，人们对将拉塔热手术作为翻修手术时的并发症更为关注。
目的
评估初次手术与翻修手术相比，拉塔热手术的早期疗效和并发症。
研究设计
队列研究；证据等级，3级。
方法
共纳入157例患者并进行回顾性分析：翻修组103例患者，初次手术组54例患者。通过体格检查结果以及从电子病历中提取的并发症和再次手术记录对患者进行评估。
结果
初次手术组的平均随访时间为7.8±11.0个月，翻修组为7.0±13.2个月。初次手术组和翻修组的总体并发症发生率无显著差异（分别为16.7%和8.7%；P = 0.139）。与仅接受关节镜手术的患者相比，翻修组中曾接受开放手术的患者并发症发生率显著更高（分别为30.0%和4.1%；P < 0.001）。在发生并发症的患者中，初次手术组9例中有7例（13.0%）接受了再次手术，翻修组9例中有7例（6.8%）接受了再次手术；两组再次手术的风险无差异（P = 0.198）。初次手术组有4例患者（7.4%），翻修组有5例患者（4.9%）在随访期间出现复发性脱位（P = 0.513）。术后活动范围无差异。
结论
拉塔热手术是治疗关节镜下不稳定修复失败的合理选择，其早期并发症发生率与初次拉塔热手术相似。
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