Dalmas Yoann, Thélu Charles-Edouard, Laumonerie Pierre, Martinel Vincent, Robert Suzanne, Mansat Pierre, Bonnevialle Nicolas
Département de Chirurgie Orthopédique et Traumatologique, CHU de Toulouse, Hopital Pierre Paul Riquet, Toulouse, France.
Clinique du Sport et de Chirurgie Orthopédique, Marcq-en-Barœul, France.
J Shoulder Elbow Surg. 2022 Dec;31(12):e603-e612. doi: 10.1016/j.jse.2022.04.004. Epub 2022 May 10.
The aim of this study was to evaluate the osteolysis rate, graft remodeling, and risk factors for osteolysis at the 1-year threshold after an arthroscopic Latarjet procedure with double-button fixation.
In this multicenter, retrospective study, postoperative computed tomography scans obtained after an arthroscopic Latarjet procedure with double-button fixation to treat anterior shoulder instability were analyzed at 15 days and at 3, 6, and 12 months. Graft volume, dimensions, and morphologic remodeling were analyzed.
Twenty-seven patients were included (mean age, 26 years). At 1 year, osteolysis occurred in 19 of 27 patients (70%). The volume initially decreased until 6 months' follow-up (-35%; range, -75% to +26%) and then increased until our last follow-up. At 1 year, the graft volume decreased by 17% (range, -61% to +56%) compared with the immediate postoperative volume. In multivariate analysis, the rate of osteolysis was inversely associated with an unhealed graft at 3 months (P = .02; β coefficient = -44.50 [95% confidence interval, -81 to -8]). The maximal height of the graft significantly grew 0.2 cm (range, -55 to +124 mm) (P = .015). In the sagittal plane, osteolysis occurred in the superior part in 100% of patients (27 of 27) whereas bone formation occurred in the inferior part. In the axial plane, osteolysis occurred in the anterior part whereas bone formation occurred in the posterior part. In the articular part, the observed remodeling was aimed to obtain a new anatomic and congruent glenoid.
At 1 year after an arthroscopic Latarjet procedure with double-button fixation, osteolysis occurred in 70% of patients. The rate of osteolysis was 17% of the initial volume. Osteolysis occurred mainly during the first 6 months, in the anterior and superior parts. Remodeling led to a circular anatomic glenoid. This osteolysis did not cause any recurrence of instability or require revision surgery.
本研究旨在评估关节镜下双纽扣固定Latarjet手术1年后的骨溶解率、移植物重塑情况以及骨溶解的危险因素。
在这项多中心回顾性研究中，对关节镜下双纽扣固定Latarjet手术治疗前肩不稳术后15天、3个月、6个月和12个月时获得的术后计算机断层扫描进行分析。分析移植物的体积、尺寸和形态重塑情况。
纳入27例患者（平均年龄26岁）。1年时，27例患者中有19例（70%）发生骨溶解。体积最初在6个月随访时下降（-35%；范围为-75%至+26%），然后在最后一次随访时增加。1年时，与术后即刻体积相比，移植物体积减少了17%（范围为-61%至+56%）。多因素分析显示，骨溶解率与3个月时移植物未愈合呈负相关（P = 0.02；β系数=-44.50 [95%置信区间，-81至-8]）。移植物的最大高度显著增加0.2 cm（范围为-55至+124 mm）（P = 0.015）。在矢状面，100%的患者（27例中的27例）在上方发生骨溶解，而在下方发生骨形成。在轴面，前部发生骨溶解，而后部发生骨形成。在关节部分，观察到的重塑旨在获得新的解剖学上一致的关节盂。
关节镜下双纽扣固定Latarjet手术1年后，70%的患者发生骨溶解。骨溶解率为初始体积的17%。骨溶解主要发生在前6个月，部位在前部和上部。重塑导致关节盂呈圆形解剖结构。这种骨溶解未导致任何不稳定复发或需要翻修手术。
