Erickson Brandon J, Shishani Yousef, Jones Stacy, Romeo Anthony A, Gobezie Reuben
Rothman Orthopaedic Institute, New York, NY, USA.
Cleveland Shoulder Institute, Beachwood, OH, USA.
JSES Int. 2020 Dec 7;5(2):175-180. doi: 10.1016/j.jseint.2020.10.009. eCollection 2021 Mar.
Latarjet has become a common treatment option for patients with shoulder instability in the setting of bone loss. The coracoid is commonly secured with screws.
All patients who underwent Latarjet with suture-button fixation with minimum 1-year follow-up were eligible for inclusion. Preoperative demographic and clinical outcome data including American Shoulder and Elbow Surgeons (ASES), Single Assessment Numerical Evaluation (SANE), and Visual Analog Scale (VAS) were recorded and compared with postoperative scores. Radiographs were reviewed for signs of nonunion. Complications were recorded.
Overall 21 patients (76% male, average age: 30.4 ± 11.3 years) underwent Latarjet with suture-button fixation. Significant improvements at 1 year were seen in ASES ( < 0.001), SANE ( < 0.001), and VAS ( = 0.011) scores compared with preoperative scores. Of the 21 patients who had reached 1-year follow-up, 17 (81%) reached 2-year follow-up. For the 17 patients who reached 2-year follow-up, there were significant improvements in ASES ( = 0.001), SANE ( = 0.001), and VAS ( = 0.005) scores from preoperative values. When isolating the 17 patients with 2-year follow-up, there were no significant differences between their 1-year and 2-year ASES ( = 0.73), SANE ( = 0.17), and VAS ( = 0.37) scores. Overall, 3 patients (14%) sustained a complication (one redislocation, one with coracoid migration and a fibrous union, and one superior labral tear requiring biceps tenodesis and superior labral repair).
Suture-button fixation of the coracoid during the Latarjet provides encouraging clinical and radiographic outcomes at 1 and 2 years.
对于存在骨质流失的肩关节不稳定患者,Latarjet手术已成为一种常用的治疗选择。喙突通常用螺钉固定。
所有接受Latarjet手术并采用缝线纽扣固定且随访至少1年的患者均符合纳入标准。记录术前人口统计学和临床结局数据,包括美国肩肘外科医师学会(ASES)评分、单评估数值评定(SANE)评分和视觉模拟量表(VAS)评分,并与术后评分进行比较。复查X线片以观察骨不连迹象。记录并发症情况。
共有21例患者(76%为男性,平均年龄:30.4±11.3岁)接受了Latarjet手术并采用缝线纽扣固定。与术前评分相比,1年时ASES评分(<0.001)、SANE评分(<0.001)和VAS评分(=0.011)有显著改善。在21例达到1年随访的患者中,17例(81%)达到了2年随访。对于17例达到2年随访的患者,ASES评分(=0.001)、SANE评分(=0.001)和VAS评分(=0.005)较术前值有显著改善。在将17例有2年随访的患者单独分析时,其1年和2年的ASES评分(=0.73)、SANE评分(=0.17)和VAS评分(=0.37)之间无显著差异。总体而言,3例患者(14%)出现并发症(1例再脱位,1例喙突移位并纤维性骨愈合,1例上盂唇撕裂需要肱二头肌固定和上盂唇修复)。
Latarjet手术中对喙突采用缝线纽扣固定在1年和2年时可提供令人鼓舞的临床和影像学结果。