Billaud Anselme, Garcia-Maya Beatriz, Pesquer Lionel, Pillot Sabine
Clinique du Sport, Mérignac, France.
Hospital Infanta Elena, Valdemoro, Madrid, Spain.
Orthop J Sports Med. 2023 Jul 31;11(7):23259671231185199. doi: 10.1177/23259671231185199. eCollection 2023 Jul.
Up to 20% of shoulders with anterior instability are associated with superior labrum anterior-posterior (SLAP) lesions, and they remain untreated after an open Latarjet procedure. SLAP lesions can be responsible for pain and feelings of instability in high-demand patients.
PURPOSE/HYPOTHESIS: The aim of this study was to compare the early functional outcomes and return to sport rates in athletes after the Latarjet procedure with versus without associated SLAP lesions. It was hypothesized that untreated SLAP lesions would not influence clinical results.
Cohort study; Level of evidence, 3.
Inclusion criteria were athletes with anterior shoulder instability treated with Latarjet procedure, a minimum follow-up of 1 year, and an available preoperative computed tomography arthrogram. We recorded patient characteristics; type of sport; bone loss; Rowe, Single Assessment Numeric Evaluation (SANE), and 11-item Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores; 5-point pain and satisfaction scores; reported apprehension; and return to sport. Patients with and without a preoperative type 5 SLAP lesion on imaging were compared.
Fifty patients were included (mean age, 22 ± 5 years [range, 16-36 years]; mean follow-up, 27 ± 9 months [range, 12-42 months]). Thirty-four patients practiced contact sports, including 20 rugby players. Twelve patients (24%) had a preoperative SLAP lesion. Groups with (+) and without (-) a SLAP lesion were comparable in terms of age, sex, number of instability episodes, type of sport, and glenoid and humeral bone loss. The SLAP+ group had significantly worse outcomes with a lower Rowe score (79 ± 23 vs 91 ± 15; = .018) and painless rate (50% vs 77%; = .04). There were no significant differences between the groups in SANE score (SLAP+ vs SLAP-: 80% vs 87%), QuickDASH score (8% vs 8%), return to sport (83% vs 91%), apprehension (79% vs 50%), and reported satisfaction. There was 1 episode of postoperative subluxation in each group.
Patients who underwent an open Latarjet procedure with an associated SLAP tear more frequently reported postoperative pain than those without a SLAP lesion. Patients with untreated SLAP tears had significantly lower Rowe scores, although SANE score and return to sport were not significantly different between the groups.
高达20%的前向不稳定肩关节与上盂唇前后部（SLAP）损伤相关，且在开放性Latarjet手术后仍未得到治疗。SLAP损伤可能导致高需求患者出现疼痛和不稳定感。
目的/假设：本研究的目的是比较接受Latarjet手术的运动员在伴有与不伴有相关SLAP损伤情况下的早期功能结果和恢复运动率。假设未治疗的SLAP损伤不会影响临床结果。
队列研究；证据等级，3级。
纳入标准为接受Latarjet手术治疗的前肩不稳定运动员、至少随访1年以及有术前计算机断层扫描关节造影。我们记录了患者特征；运动类型；骨质流失情况；Rowe评分、单项评估数字评价（SANE）评分以及手臂、肩部和手部功能障碍的11项评分（QuickDASH）；5分制疼痛和满意度评分；报告的恐惧情况；以及恢复运动情况。对影像学检查术前有和无5型SLAP损伤的患者进行比较。
共纳入50例患者（平均年龄22±5岁[范围16 - 36岁]；平均随访27±9个月[范围12 - 42个月]）。34例患者从事对抗性运动，包括20名橄榄球运动员。12例患者（24%）术前有SLAP损伤。伴有（+）和不伴有（-）SLAP损伤的两组在年龄、性别、不稳定发作次数、运动类型以及肩胛盂和肱骨骨质流失方面具有可比性。SLAP阳性组的结果明显更差，Rowe评分更低（79±23对91±15；P = 0.018），无痛率更低（50%对77%；P = 0.04）。两组在SANE评分（SLAP +组对SLAP -组：80%对87%）、QuickDASH评分（8%对8%）、恢复运动情况（83%对91%）、恐惧情况（79%对50%）以及报告的满意度方面无显著差异。每组各有1例术后半脱位情况。
接受开放性Latarjet手术且伴有SLAP撕裂的患者比无SLAP损伤的患者术后疼痛报告更为频繁。未治疗SLAP撕裂的患者Rowe评分明显更低，尽管两组之间SANE评分和恢复运动情况无显著差异。
