Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2312-2324. doi: 10.1007/s00167-020-06263-3. Epub 2020 Sep 16.
Age at primary dislocation, recurrence, and glenoid bone loss are associated with development of osteoarthritis (OA). However, an overview of OA following traumatic anterior shoulder instability is lacking and it is unclear to what degree type of surgery is associated with development of OA in comparison to non-operative treatment. The aim of this study was to determine the degree of OA at long-term follow-up after non-operative and operative treatments for patients with anterior shoulder instability. Surgery is indicated when patients experience recurrence and this is associated with OA; therefore, it was hypothesized that shoulders show a higher proportion or degree of OA following operative treatment compared to non-operative treatment.
A literature search was performed in the PubMed/Medline, EMBASE, and Cochrane databases. Articles reporting the degree of OA that was assessed with the Samilson-Prieto or Buscayret OA classification method after non-operative and operative treatment for anterior shoulder instability with a minimum of 5 years follow-up were included.
Thirty-six articles met the eligibility criteria of which 1 reported the degree of OA for non-operative treatment and 35 reported the degree of OA for 9 different operative procedures. A total of 1832 patients (1854 shoulders) were included. OA proportions of non-operative and operative treatments are similar at any point of follow-up. The Latarjet procedure showed a lower degree of OA compared to non-operative treatment and the other operative procedures, except for the Bristow procedure and Rockwood capsular shift. The meta-analyses showed comparable development of OA over time among the treatment options. An increase in OA proportion was observed when comparing the injured to the contralateral shoulder. However, a difference between the operative subgroups was observed in neither analysis.
Non-operative and operative treatments show similar OA proportions at any point of follow-up. The hypothesis that shoulders showed a higher proportion or degree of OA following operative treatment compared to non-operative treatment is not supported by the data. Operative treatment according to the Latarjet procedure results in a lower degree of OA compared to other treatments, including non-operative treatment.
IV.
初次脱位时的年龄、复发和肩胛盂骨丢失与骨关节炎（OA）的发展有关。然而，对于创伤性前肩不稳定后 OA 的概述尚不清楚，并且不清楚手术与非手术治疗相比与 OA 的发展有多大程度的关联。本研究的目的是确定非手术和手术治疗前肩不稳定患者长期随访时 OA 的程度。当患者经历复发且与 OA 相关时，需要进行手术；因此，假设与非手术治疗相比，手术后肩部显示出更高比例或更严重的 OA。
在 PubMed/Medline、EMBASE 和 Cochrane 数据库中进行文献检索。纳入了报告至少 5 年随访的非手术和手术治疗前肩不稳定后使用 Samilson-Prieto 或 Buscayret OA 分类方法评估 OA 程度的文章。
符合条件的 36 篇文章中有 1 篇报告了非手术治疗的 OA 程度，35 篇报告了 9 种不同手术方法的 OA 程度。共纳入 1832 例患者（1854 肩）。在任何随访点，非手术和手术治疗的 OA 比例相似。与非手术治疗和其他手术方法相比，Latarjet 手术显示出较低的 OA 程度，除了 Bristow 手术和 Rockwood 囊袋移位。Meta 分析显示，随着时间的推移，各种治疗方法的 OA 发展情况相似。与对侧肩部相比，受伤肩部的 OA 比例增加。然而，在这两种分析中均未观察到手术亚组之间的差异。
在任何随访点，非手术和手术治疗的 OA 比例相似。与非手术治疗相比，手术后肩部表现出更高比例或更严重的 OA 的假设没有得到数据的支持。与其他治疗方法（包括非手术治疗）相比，Latarjet 手术导致的 OA 程度较低。
IV。
