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开放性Latarjet手术术后的功能缺陷与患侧肩部优势:133例患者的分析

Functional Deficits After Open Latarjet Procedure and Dominance of the Operated Shoulder: An Analysis of 133 Patients.

作者信息

Rogowski Isabelle, Nové-Josserand Laurent, Godenèche Arnaud, Colotte Philippe, Franger Gabriel, Vigne Grégory, Vieira Thais Dutra, Blache Yoann, Neyton Lionel

机构信息

Université de Lyon, Université Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité-EA 7424, Villeurbanne Cedex, France.

Ramsay Santé, Hôpital Privé Jean Mermoz, Lyon, France.

出版信息

Am J Sports Med. 2023 Apr;51(5):1277-1285. doi: 10.1177/03635465231156181. Epub 2023 Feb 27.

Abstract

BACKGROUND

Return to sport after stabilization surgery using the open Latarjet procedure remains challenging. Additional knowledge is needed about postoperative shoulder functional deficits in order to better design return-to-sport programs.

PURPOSE

To investigate the effects of the dominance status of the operated shoulder on the shoulder functional profile recovery at 4.5 months after open Latarjet procedure.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A retrospective analysis of prospectively collected data was performed. All patients who underwent the open Latarjet procedure between December 2017 and February 2021 were eligible for the study. Functional assessment at 4.5 months after the surgery was performed using the following tests: maximal voluntary isometric contractions in glenohumeral internal and external rotation, upper-quarter Y balance test, unilateral seated shot-put test, and modified closed kinetic chain upper extremity stability test, leading to 10 outcome measures. Patients whose dominant side had undergone surgery and those whose nondominant side had undergone surgery were compared with a group of 68 healthy control participants.

RESULTS

A total of 72 patients who underwent an open Latarjet procedure on the dominant side and 61 patients who underwent open Latarjet on the nondominant side were compared with 68 healthy control athletes. In patients whose dominant shoulder had undergone surgery, significant deficits for the dominant side ( < .001) and for the nondominant side ( < .001) were found in 9 of 10 functional outcome measures. Among patients whose operations were on the nondominant shoulder, significant deficits for the nondominant side ( < .001) and for the dominant side ( < .001) were found in 9 and 5 of the 10 functional outcome measures, respectively.

CONCLUSION

Regardless of dominance of the stabilized shoulder, persistent deficits in strength, stability, mobility, power, and stroke frequency were observed at 4.5 months postoperatively. Stabilization of the dominant shoulder resulted in residual surgery-related functional impairments on both sides. However, stabilization of the nondominant shoulder resulted in impairments primarily noted in the nondominant, operative shoulder.

REGISTRATION

NCT05150379 (ClinicalTrials.gov identifier).

摘要

背景

采用开放式拉塔热手术进行稳定手术后恢复运动仍然具有挑战性。需要更多关于术后肩部功能缺陷的知识,以便更好地设计恢复运动计划。

目的

研究开放式拉塔热手术后4.5个月时,手术侧肩部的优势状态对肩部功能恢复情况的影响。

研究设计

横断面研究;证据等级:3级。

方法

对前瞻性收集的数据进行回顾性分析。所有在2017年12月至2021年2月期间接受开放式拉塔热手术的患者均符合研究条件。术后4.5个月时使用以下测试进行功能评估:盂肱关节内旋和外旋的最大自主等长收缩、上肢Y平衡测试、单侧坐姿推铅球测试以及改良的闭链上肢稳定性测试,共得出10项结果指标。将手术侧为优势侧和非优势侧的患者与68名健康对照参与者进行比较。

结果

共将72例优势侧接受开放式拉塔热手术的患者和61例非优势侧接受开放式拉塔热手术的患者与68名健康对照运动员进行了比较。在优势侧接受手术的患者中,10项功能结果指标中有9项在优势侧(P < .001)和非优势侧(P < .001)发现显著缺陷。在非优势侧接受手术的患者中,10项功能结果指标分别有9项(P < .001)和5项(P < .001)在非优势侧和优势侧发现显著缺陷。

结论

无论稳定的肩部是否为优势肩,术后4.5个月时均观察到力量、稳定性、活动度、力量和冲程频率持续存在缺陷。优势肩的稳定导致两侧均出现与手术相关的残余功能障碍。然而,非优势肩的稳定导致的功能障碍主要出现在非优势手术侧肩部。

注册信息

NCT05150379(ClinicalTrials.gov标识符)

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