与开放Latarjet手术相比，关节镜下Latarjet手术后螺钉相关并发症的发生率可能更高：一项系统评价。
Screw-Related Complications May Occur at a Greater Rate After Arthroscopic Versus Open Latarjet Procedure: A Systematic Review.
作者信息
Lacouture-Suarez Juan David, Azar Michel, Brusalis Christopher M, Ranieri Riccardo, Brotat-Rodriguez Maria, Boileau Pascal
机构信息
ICR-Institut de Chirurgie Réparatrice - Groupe KANTYS, Institute for Sports & Reconstructive Surgery, Nice, France.
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
出版信息
Arthrosc Sports Med Rehabil. 2023 Jun 18;5(4):100726. doi: 10.1016/j.asmr.2023.04.010. eCollection 2023 Aug.
PURPOSE
To determine the rate of complications attributable to the use of screw fixation during the Latarjet procedure and to delineate screw-related complications for open and arthroscopic Latarjet surgery.
METHODS
A systematic review of the literature was performed by querying MEDLINE and EMBASE computerized databases for relevant articles that reported clinical outcomes associated with the Latarjet procedure. Clinical studies of open and/or arthroscopic Latarjet surgery that employed screw fixation of the coracoid were included in our analysis.
RESULTS
From 692 articles identified initially, 32 studies met eligibility criteria. The study cohort comprised 2,758 shoulders, with a mean age of patients ranged from 17 to 62 years, and the mean duration of follow-up ranged from 0.3 to 25.6 years. Twenty-two studies reported outcomes of an open Latarjet technique whereas 10 studies reported on an arthroscopic Latarjet technique. Across all studies, the overall complication rate ranged from 1.4% to 36%. The rate of screw-related complications ranged from 0% to16%, and the rate of screw removal ranged from 0% to 18%. Among the subset of studies that reported specific indications for screw removal, the most common indications were pain and screw loosening. Reported rates of screw-removal among arthroscopic Latarjet procedures range from 0% to 18% and among open procedures range from 0% to 7.3%.
CONCLUSIONS
(1) Up to one-third of the overall surgical complications associated with the Latarjet procedure may be related to the use of screw fixation, (2) arthroscopic Latarjet procedure did not decrease the rate of screw related complications. The reported rate of screw-removal may be higher after the arthroscopic Latarjet procedures (up to 18%) than after open procedures (up to 7,3%), and is mainly indicated for persistent shoulder pain and/or screw loosening.
LEVEL OF EVIDENCE
Level IV, systematic review of Level III-IV studies.
目的
确定拉塔热手术中使用螺钉固定导致的并发症发生率，并描述开放和关节镜下拉塔热手术中与螺钉相关的并发症。
方法
通过查询MEDLINE和EMBASE计算机数据库对相关文献进行系统综述，以获取报告拉塔热手术临床结果的相关文章。我们的分析纳入了采用喙突螺钉固定的开放和/或关节镜下拉塔热手术的临床研究。
结果
从最初识别的692篇文章中，有32项研究符合纳入标准。研究队列包括2758例肩部病例，患者平均年龄在17至62岁之间，平均随访时间在0.3至25.6年之间。22项研究报告了开放拉塔热技术的结果，而10项研究报告了关节镜下拉塔热技术的结果。在所有研究中，总体并发症发生率在1.4%至36%之间。与螺钉相关的并发症发生率在0%至16%之间，螺钉取出率在0%至18%之间。在报告了螺钉取出具体指征的研究子集中，最常见的指征是疼痛和螺钉松动。关节镜下拉塔热手术的螺钉取出率报告在0%至18%之间，开放手术的螺钉取出率在0%至7.3%之间。
结论
（1）与拉塔热手术相关的总体手术并发症中，高达三分之一可能与螺钉固定的使用有关；（2）关节镜下拉塔热手术并未降低与螺钉相关的并发症发生率。关节镜下拉塔热手术后报告的螺钉取出率（高达18%）可能高于开放手术后（高达7.3%），主要指征是持续的肩部疼痛和/或螺钉松动。
证据级别
IV级，III-IV级研究的系统综述。
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