Tanaka Makoto, Hanai Hiroto, Kotani Yuki, Kuratani Kosuke, Nakai Hidekazu, Kinoshita Shuma, Hirose Takehito, Hayashida Kenji
Center for Sports Medicine, Daini Osaka Police Hospital, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Orthop J Sports Med. 2022 May 12;10(5):23259671221095094. doi: 10.1177/23259671221095094. eCollection 2022 May.
Coracoid transfer is a reliable method for managing anterior shoulder instability in athletes who play contact sports; however, differences between the Bristow and Latarjet procedures are unclear.
To compare clinical outcomes and rates of bone union and bone resorption of the coracoid process between the open Bristow and open Latarjet procedures in rugby players.
Cohort study; Level of evidence, 3.
Rugby players who underwent an open Bristow or an open Latarjet procedure were retrospectively reviewed for anterior shoulder instability, and 66 shoulders in the Bristow group and 35 in the Latarjet group were included. Graft union and resorption were evaluated using computed tomography at 3 months to 1 year postoperatively. Patient-reported outcome measures (American Shoulder and Elbow Surgeons score, Rowe score, and satisfaction rate) were obtained at a mean follow-up of 74 months (range, 45-160 months) for Bristow and 64 months (range, 50-76 months) for Latarjet procedures. Recurrence and the rate of return to play (RTP), frequency of pain after RTP, and retirement rate after RTP were also assessed.
In 97.1% of the Latarjet procedure cases, bone union of the coracoid was achieved at 3 months postoperatively; however, bone union was achieved in only 72.7% of the Bristow procedure cases at 6 months postoperatively. Bone resorption of the coracoid process occurred in 6.1% of shoulders after the Bristow procedure, whereas 100% of shoulders showed bone resorption after the Latarjet procedure. No statistical differences were found in outcome scores between the 2 procedures. Subluxation and persistent pain after returning to sports were identified at a significantly higher rate in the Latarjet group (5 shoulders [14%] and 9 shoulders [26%], respectively) than in the Bristow group (2 shoulders [3%] and 2 shoulders [3%]) ( = .0471 and = .001, respectively).
The Latarjet procedure had an advantage in the early and high rate of bone union but was at a disadvantage in bone resorption compared with the Bristow procedure. Subluxation and pain after returning to sports were more frequent in patients who underwent the open Latarjet procedure than in those who underwent the open Bristow procedure.
喙突转移术是治疗从事接触性运动的运动员前肩不稳的可靠方法；然而，布里斯托（Bristow）手术和拉塔热（Latarjet）手术之间的差异尚不清楚。
比较橄榄球运动员开放性布里斯托手术和开放性拉塔热手术的临床疗效、喙突骨愈合率和骨吸收情况。
队列研究；证据等级为3级。
对接受开放性布里斯托或开放性拉塔热手术治疗前肩不稳的橄榄球运动员进行回顾性分析，布里斯托组纳入66例肩部病例，拉塔热组纳入35例。术后3个月至1年采用计算机断层扫描评估移植物愈合和吸收情况。在布里斯托手术平均随访74个月（范围45 - 160个月）和拉塔热手术平均随访64个月（范围50 - 76个月）时，获取患者报告的结局指标（美国肩肘外科医师评分、罗伊（Rowe）评分和满意率）。还评估了复发率、重返运动率（RTP）、RTP后疼痛频率以及RTP后的退役率。
在97.1%的拉塔热手术病例中，术后3个月实现了喙突骨愈合；然而，在布里斯托手术病例中，术后6个月仅有72.7%实现了骨愈合。布里斯托手术后6.1%的肩部出现喙突骨吸收，而拉塔热手术后100%的肩部出现骨吸收。两种手术的结局评分无统计学差异。拉塔热组（分别为5例肩部[14%]和9例肩部[26%]）重返运动后半脱位和持续疼痛的发生率显著高于布里斯托组（分别为2例肩部[3%]和2例肩部[3%]）（分别为P = 0.0471和P = 0.001）。
与布里斯托手术相比，拉塔热手术在早期和高骨愈合率方面具有优势，但在骨吸收方面处于劣势。接受开放性拉塔热手术的患者重返运动后半脱位和疼痛比接受开放性布里斯托手术的患者更频繁。
