Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
Arthroscopy. 2021 Nov;37(11):3248-3252. doi: 10.1016/j.arthro.2021.04.059. Epub 2021 May 5.
To assess recurrent instability of the shoulder following open Latarjet performed as the primary stabilization procedure or as a salvage procedure.
A retrospective, comparative cohort study was performed for a consecutive series of patients in the Military Health System who underwent open Latarjet from January 1, 2010, to December 31, 2018. All patients were diagnosed with recurrent anterior shoulder instability and had a minimum of 2 years of postoperative follow-up. Patients were categorized as either having a primary Latarjet (PL; no prior shoulder stabilization procedure) or salvage Latarjet (SL; ≥1 previous arthroscopic surgical stabilization procedures).
A total of 234 Latarjet procedures were performed in 234 patients. The overall recurrent instability rate was 15.8% (37/234), the overall reoperation rate was 16.7% (36/234), and the overall complication rate was 14.2% (33/234) over a mean 5.0 years of follow-up. There were 99 PL procedures and 135 SL procedures. The SL group had significantly more recurrent instability than the PL group (SL 28/135, 20.7%; PL 9/99, 9.1%; P = .0158). There was no difference in overall reoperation rates (SL 26/135, 19.3%; PL 13/99, 13.1%; P = .2140) or complication rates (SL 20/135, 14.8%; PL 13/99, 13.3%; P = .9101).
The rate of recurrent instability following the Latarjet procedure in an active, high-risk population is 15.8%. Primary Latarjet was found to have lower rates of recurrence compared with salvage Latarjet procedures (9.1% versus 20.7%).
III.
评估开放式 Latarjet 手术作为初次稳定术或挽救性手术治疗后肩部的复发性不稳定。
对 2010 年 1 月 1 日至 2018 年 12 月 31 日期间，在军事医疗系统中连续系列接受开放式 Latarjet 手术的患者进行回顾性、比较队列研究。所有患者均被诊断为复发性前肩不稳定，并至少有 2 年的术后随访。患者分为原发性 Latarjet（PL；无先前肩稳定手术）或挽救性 Latarjet（SL；≥1 次关节镜下手术稳定术）。
234 名患者共行 234 次 Latarjet 手术。总的复发性不稳定率为 15.8%（37/234），总的再手术率为 16.7%（36/234），平均随访 5.0 年后总体并发症发生率为 14.2%（33/234）。PL 组 99 例，SL 组 135 例。SL 组的复发性不稳定发生率明显高于 PL 组（SL 28/135，20.7%；PL 9/99，9.1%；P=0.0158）。两组总体再手术率（SL 26/135，19.3%；PL 13/99，13.1%；P=0.2140）或并发症发生率（SL 20/135，14.8%；PL 13/99，13.3%；P=0.9101）无差异。
在活跃的高风险人群中，Latarjet 手术后复发性不稳定的发生率为 15.8%。原发性 Latarjet 与挽救性 Latarjet 手术相比，复发率较低（9.1%比 20.7%）。
III 级。
