Alps Surgery Institute, Clinique Générale Annecy, Annecy, France; Department of Orthopaedics, University of Zurich, Balgrist University Hospital, Zurich, Switzerland.
Alps Surgery Institute, Clinique Générale Annecy, Annecy, France; Ortomove, Centro Medico ABC, Mexico City, Mexico.
Arthroscopy. 2021 Mar;37(3):816-823. doi: 10.1016/j.arthro.2020.10.052. Epub 2020 Dec 29.
To examine the long-term clinical outcome associated with arthroscopically placed autologous iliac crest bone graft (ICBG) for recurrent posterior shoulder instability.
From January 2008 to December 2013, patients treated with posterior ICBG and a minimum follow-up of 5 years were included. Clinical outcome of patients operated with a posterior ICBG was analyzed with multiple patient-reported outcome measures included Constant (CS), American Shoulder and Elbow Surgeons (ASES), Walch-Duplay, and Rowe scores, shoulder subjective value, and pain visual analog score. Patient satisfaction was assessed by asking the patients their overall level of satisfaction at last follow-up on a 1 to 10 scale.
In total, 18 patients (19 shoulders) were included. At a mean follow-up of 7.3 years (range, 5-10 years), patients had significant improvements in their mean CS from 63 (standard deviation [SD] 18) to 80 (SD 18; P = .005), ASES from 57 (SD 18) to 81 (SD 18; P = .003), Walch-Duplay from 34 (SD 31) to 79 (SD 22; P < .001), and Rowe score from 37 (SD 23) to 79 (SD 24; P < .001). Pain level decreased from 5.6 (SD 2.5) preoperative to 2.3 (SD 2.3; P < .001) and shoulder subjective value improved 58 (SD 20) to 76 (SD 24; P = .002). Global satisfaction with the procedure was 8.4 (SD 2.1). Clinical significance was met or exceeded by 84% for CS and 89% of the patients for ASES and 95% met or exceeded satisfaction threshold for CS. There were 7 shoulders (37%) reoperated for symptomatic screw irritation.
This series reporting on the long-term follow-up after arthroscopic posterior ICBG for recurrent posterior shoulder instability demonstrates, despite a high number of reoperations for symptomatic screw irritation, its effectiveness with acceptable clinical outcomes and satisfied patients.
IV, therapeutic case series.
研究关节镜下自体髂嵴骨移植（ICBG）治疗复发性肩关节后向不稳定的长期临床疗效。
从 2008 年 1 月至 2013 年 12 月，我们纳入了接受关节镜下 ICBG 治疗且随访时间至少 5 年的患者。通过使用多个患者报告的结果测量指标（包括 Constant（CS）、美国肩肘外科医生（ASES）、Walch-Duplay 和 Rowe 评分、肩关节主观价值和疼痛视觉模拟评分）分析接受关节镜下 ICBG 治疗的患者的临床结果。通过询问患者在最后一次随访时的整体满意度（1-10 分）来评估患者满意度。
共有 18 名患者（19 个肩关节）被纳入研究。平均随访 7.3 年（范围，5-10 年），患者的 CS 平均值从 63（标准差 [SD] 18）提高到 80（SD 18；P=.005），ASES 从 57（SD 18）提高到 81（SD 18；P=.003），Walch-Duplay 从 34（SD 31）提高到 79（SD 22；P<.001），Rowe 评分从 37（SD 23）提高到 79（SD 24；P<.001）。疼痛水平从术前的 5.6（SD 2.5）降至 2.3（SD 2.3；P<.001），肩关节主观价值从 58（SD 20）提高到 76（SD 24；P=.002）。患者对手术的整体满意度为 8.4（SD 2.1）。84%的患者 CS 评分和 89%的患者 ASES 评分达到或超过临床显著水平，95%的患者 CS 评分达到或超过满意度阈值。有 7 个肩关节（37%）因症状性螺钉刺激而再次手术。
本系列报告了关节镜下后向 ICBG 治疗复发性肩关节后向不稳定的长期随访结果，尽管有大量因症状性螺钉刺激而再次手术，但仍具有有效性，且临床结果可接受，患者满意度高。
IV，治疗性病例系列研究。
