Sy Joshua W, Cruz Christian A, Daner William E, Bottoni Craig R, Min Kyong S
Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Jun 25;4(4):e1445-e1448. doi: 10.1016/j.asmr.2022.04.035. eCollection 2022 Aug.
To evaluate the return to duty rates between subscapularis split versus subscapularis tenotomy approach to the Latarjet procedure in an active-duty military population.
A total of 46 patients were identified. Thirty-six (87.8%) were able to be contacted and included in the study. Operative technique, time to return to duty, and postoperative range of motion were collected. Patients were contacted telephonically to collect information on recurrent dislocation and time to pass first physical fitness test postoperatively. The primary outcome was time to return to full-duty status designated by passing a Physical Fitness Test. Secondary outcomes were redislocations and final range of motion.
In total, 36 of 41 (87.8%) patients were able to be contacted. There was no difference in return to duty rates designated by completion of first Physical Fitness Test for both groups ( = .23). In the subscapularis split group, 22 of 23 patients returned to full-duty at an average of 8.0 months versus the tenotomy group, with 12 of 13 patients returned to full-duty at an average of 8.7 months. There was also no difference with re-dislocation incidence for both groups of 0.08 ( = .45). Both groups had one patient each who was unable to return to full duty. There were no differences in postoperative forward flexion and external rotation, but abduction was 9° higher in the split compared to the tenotomy group ( = .03).
In the military patient with anterior glenohumeral instability, the Latarjet using the subscapularis split and subscapularis tenotomy approach demonstrate similar return to duty rates and similar duration to pass a standardized fitness assessment. There was no clinically significant difference in postoperative range of motion. Both approaches produce similar results clinically; and should be chosen based on surgeon preference.
III, retrospective cohort study.
评估现役军人中，在Latarjet手术中采用肩胛下肌劈开术与肩胛下肌肌腱切断术两种方法后的复职率。
共确定了46例患者。其中36例（87.8%）能够取得联系并纳入研究。收集了手术技术、复职时间和术后活动范围等信息。通过电话联系患者，收集有关复发性脱位和术后首次通过体能测试时间的信息。主要结局指标是通过体能测试确定的恢复全职状态的时间。次要结局指标是再脱位和最终活动范围。
总共41例患者中有36例（87.8%）能够取得联系。两组完成首次体能测试后的复职率没有差异（P = 0.23）。在肩胛下肌劈开术组中，23例患者中有22例平均在8.0个月后恢复全职，而肌腱切断术组中，13例患者中有12例平均在8.7个月后恢复全职。两组的再脱位发生率也没有差异，均为0.08（P = 0.45）。两组各有1例患者无法恢复全职。术后前屈和外旋没有差异，但劈开术组的外展比肌腱切断术组高9°（P = 0.03）。
对于患有前盂肱关节不稳的军人患者，采用肩胛下肌劈开术和肩胛下肌肌腱切断术的Latarjet手术显示出相似的复职率和通过标准化体能评估的相似时间。术后活动范围没有临床显著差异。两种方法在临床上产生相似的结果；应根据外科医生的偏好进行选择。
III级，回顾性队列研究。
