Bonnevialle Nicolas, Mattési Lucas, Martinel Vincent, Letartre Romain, Barret Hugo, Mansat Pierre
Clinique Universitaire du Sport, CHU de Toulouse, Toulouse, France.
Clinique Pyrénées-Ormeaux, Groupe Elsan, Tarbes, France.
Orthop J Sports Med. 2023 Aug 8;11(8):23259671231184394. doi: 10.1177/23259671231184394. eCollection 2023 Aug.
Because rugby is a collision sport, it exposes players to a high risk of recurrence after anterior shoulder stabilization. Therefore, the choice of surgical procedure warrants close attention in order to optimize the time to return to sport and the stability of the shoulder throughout the player's career.
The open Latarjet procedure would allow for a faster return to play and provide a lower rate of recurrence than the open Bankart repair at long-term follow-up.
Cohort study; Level of evidence, 3.
The study retrospectively enrolled 62 competitive rugby players who had undergone an anterior shoulder instability procedure and had at least 5 years of follow-up data. A total of 32 players treated with an open Bankart repair (BK group) were compared with 30 players (31 shoulders) treated with an open Latarjet procedure (LT group). Outcomes between groups were compared with the Rowe score, Walch-Duplay score, recurrence rate, and osteoarthritis evaluation on plain radiograph (Samilson classification).
The recurrence rate was significantly higher at 18.8% for the BK group (mean follow-up, 6.9 ± 1.7 years) compared with 3.3% for the LT group (mean follow-up, 6.2 ± 1.4 years) ( = .04). No postoperative complications occurred in the BK group, whereas 1 infection and 1 hematoma required a second surgery in the LT group ( = .14). In the BK and LT groups, 97% and 90% of players, respectively, were able to return to rugby at the same level or higher ( = .27), at a mean time of 8 and 6.3 months, respectively ( = .03). The mean Rowe and Walch-Duplay scores were not significantly different between the groups; however, the osteoarthritis rate was significantly higher in the BK versus the LT group (68% vs 38%, respectively; = .03); 23% of patients, all in the BK group, had Samilson grade 2 osteoarthritis.
The open Latarjet procedure outperformed the open Bankart procedure in terms of stability, time to return to play, and radiological outcomes at long-term follow-up in competitive rugby players.
由于橄榄球是一项碰撞性运动，在前肩稳定手术后，运动员面临较高的复发风险。因此，手术方式的选择值得密切关注，以便在运动员的整个职业生涯中优化恢复运动的时间和肩部的稳定性。
在长期随访中，开放性Latarjet手术比开放性Bankart修复术能更快恢复运动且复发率更低。
队列研究；证据等级，3级。
该研究回顾性纳入了62名接受过前肩不稳手术且有至少5年随访数据的竞技橄榄球运动员。将32名接受开放性Bankart修复术治疗的运动员（BK组）与30名接受开放性Latarjet手术治疗的运动员（31例肩部，LT组）进行比较。采用Rowe评分、Walch-Duplay评分、复发率以及X线平片上的骨关节炎评估（Samilson分类）对两组间的结果进行比较。
BK组（平均随访6.9±1.7年）的复发率显著高于LT组（平均随访6.2±1.4年），分别为18.8%和3.3%（P = 0.04）。BK组未发生术后并发症，而LT组有1例感染和1例血肿需要二次手术（P = 0.14）。在BK组和LT组中，分别有97%和90%的运动员能够在平均8个月和6.3个月时以相同或更高水平重返橄榄球运动（P = 0.27）。两组间Rowe和Walch-Duplay评分的均值无显著差异；然而，BK组的骨关节炎发生率显著高于LT组（分别为68%和38%；P = 0.03）；23%的患者（均在BK组）有Samilson 2级骨关节炎。
在竞技橄榄球运动员的长期随访中，开放性Latarjet手术在稳定性、恢复运动时间和影像学结果方面优于开放性Bankart手术。
