Malahias Michael-Alexander, Mitrogiannis Leonidas, Gerogiannis Dimitrios, Chronopoulos Efstathios, Kaseta Maria-Kyriaki, Antonogiannakis Emmanouil
3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece.
Orthopaedic Department, Evangelismos General Hospital, Athens, Greece.
Shoulder Elbow. 2021 Apr;13(2):168-180. doi: 10.1177/1758573219872512. Epub 2019 Sep 11.
New types of glenoid bone block fixation, involving suture buttons, suture anchors or even implant-free impaction of the graft, have been recently introduced. In contrast to screws which allow for a rigid fixation of the bone block, these alternative procedures provide a non-rigid type of fixation.
Two reviewers independently conducted the search in a systematic way (according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms "Latarjet" OR "Eden-Hybbinette" OR "bone block" AND "anterior" AND "shoulder" AND "instability."
Eight out of the 325 initial studies were finally chosen according to our inclusion-exclusion criteria. In total, 750 patients were included in this review. The overall anterior instability recurrence rate for patients treated with non-rigid fixation was 2.6%, while the overall rate of non-union or graft osteolysis was 5.4%.
Regardless of the graft type, bone block non-rigid fixation showed satisfactory clinical and functional outcomes for the treatment of anterior shoulder instability with substantial glenoid bone deficiency. Furthermore, non-rigid fixation resulted in adequate bone graft healing and osseous incorporation. Lastly, given the relative lack of data, further prospective controlled studies are required to assess bone block non-rigid fixation procedures in comparison with the traditional rigid (with screws) fixation techniques.
Systematic review, IV.
新型的关节盂骨块固定方法，包括使用缝线纽扣、缝线锚钉，甚至是无植入物的骨块嵌压，最近已被引入。与允许骨块刚性固定的螺钉不同，这些替代方法提供了一种非刚性的固定方式。
两名评价者按照系统评价和Meta分析的首选报告项目（PRISMA），以系统的方式独立进行检索，使用MEDLINE/PubMed数据库和Cochrane系统评价数据库。使用“Latarjet”或“Eden-Hybbinette”或“骨块”以及“前方”和“肩部”和“不稳定”等术语对这些数据库进行查询。
根据我们的纳入和排除标准，最终从325项初始研究中选择了8项。本综述共纳入750例患者。采用非刚性固定治疗的患者总体前方不稳定复发率为2.6%，而骨不连或植骨骨溶解的总体发生率为5.4%。
无论植骨类型如何，骨块非刚性固定在治疗伴有严重关节盂骨缺损的前方肩部不稳定方面显示出令人满意的临床和功能结果。此外，非刚性固定导致植骨愈合良好且骨融合充分。最后，鉴于相对缺乏数据，需要进一步进行前瞻性对照研究，以评估骨块非刚性固定方法与传统刚性（螺钉）固定技术相比的效果。
系统评价，IV级
