Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, HI, USA.
Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, HI, USA.
J Shoulder Elbow Surg. 2022 Mar;31(3):629-633. doi: 10.1016/j.jse.2021.08.015. Epub 2021 Sep 16.
The arthroscopic Bankart repair in the setting of glenoid bone loss has high rates of failure. In patients with anterior glenoid bone loss, the Latarjet provides glenohumeral stability through restoration of the glenoid bone, the conjoint tendon acting as a sling on the subscapularis, and anterior capsulolabral repair. Active-duty military personnel are at high risk for glenohumeral instability and have been equated to the contact athlete; most are young, male, and engage in contact sports. The purpose of this study is to assess the return to full-duty rates in active-duty military personnel following the Latarjet for anterior glenohumeral instability with glenoid bone loss.
A retrospective review of all glenohumeral instability procedures were reviewed at a tertiary training hospital from June 2014 to June 2019. The patient population consisted of active-duty military personnel with glenoid bone loss and anterior glenohumeral instability, who were treated with a Latarjet. The primary outcome was return to full-duty status.
There were 50 patients identified for the study. Four patients were lost to follow-up, leaving 46 of 50 patients (92.0%) eligible for this study. The average age at the time of the index procedure was 23.1 years. The average percentage bone loss was 18.4%. Forty-one patients (89.1%) were able to return to full-duty status. Four patients (8.7%) sustained a recurrent dislocation following the Latarjet; all 4 dislocations occurred during a combat deployment. Four patients (8.7%) reported episodes of subluxation without dislocation. Forty-one patients (89.1%) reported that their shoulders felt stable, and we found an average return to full duty at 5.3 months CONCLUSION: In our active-duty military cohort, we found an 8.7% rate of recurrent instability after a Latarjet procedure, and 41 patients (89.1%) were able to return to full-duty status. In conclusion, the Latarjet procedure in the active-duty military population with anterior glenoid bone loss resulted in a high rate of return to duty, excellent functional outcomes, low rate of recurrent instability, and a low overall complication rate.
在存在肩胛盂骨缺损的情况下，关节镜下 Bankart 修复术的失败率很高。在存在前肩胛盂骨缺损的患者中，Latarjet 通过恢复肩胛盂、联合肌腱作为肩胛下肌吊带以及前关节囊盂唇修复来提供肩盂肱稳定性。现役军人患肩盂肱不稳定的风险很高，与接触性运动员相当；他们大多是年轻男性，从事接触性运动。本研究的目的是评估在存在肩胛盂骨缺损和前肩盂肱不稳定的现役军人中，行 Latarjet 手术后恢复全负荷工作的比例。
回顾性分析 2014 年 6 月至 2019 年 6 月在一家三级培训医院进行的所有肩盂肱不稳定手术。患者人群为患有肩胛盂骨缺损和前肩盂肱不稳定、接受 Latarjet 治疗的现役军人。主要结果是恢复全负荷工作状态。
研究共纳入 50 例患者。4 例患者失访，50 例患者中有 46 例（92.0%）符合本研究条件。指数手术时的平均年龄为 23.1 岁。平均骨缺损百分比为 18.4%。41 例（89.1%）患者能够恢复全负荷工作状态。4 例（8.7%）患者在 Latarjet 手术后发生复发性脱位；所有 4 例脱位均发生在战斗部署期间。4 例（8.7%）患者报告有半脱位而无脱位。41 例（89.1%）患者报告其肩部感觉稳定，平均在 5.3 个月时恢复全负荷工作。结论：在我们的现役军人队列中，Latarjet 手术后的复发性不稳定发生率为 8.7%，41 例（89.1%）患者能够恢复全负荷工作状态。总之，在存在前肩胛盂骨缺损的现役军人中，Latarjet 手术可获得较高的恢复工作率、良好的功能结果、较低的复发性不稳定率和较低的总体并发症发生率。
