Pan Danhong, Suo Yan, Chen Qiang, Hou Dongjie, Zhang Lanlan
Plastic and Reconstructive Surgery Center, Department of Hand and Reconstructive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.
Int Wound J. 2023 Sep 26;21(2). doi: 10.1111/iwj.14412.
The Latarjet procedure is the accepted method of operation for patients with anterior shoulder instability. However, as arthroscopy becomes more and more popular, more and more patients are being treated with minimally invasive techniques for the treatment of anteriorly unstable shoulder. This research aims to compare the curative effects of arthroscopic Latarjet (AL) and open Latarjet (OL) on postoperative anterior shoulder instability. Our hypothesis is that arthroscopy will produce better results than open surgery. During the study, a review was conducted on four main databases, including EMBASE and Cochrane Library. Six cohort studies comparing AL with OL in the treatment of anterior shoulder instability were included. Patients who were operated by open technique up to 2023 were referred to as OL and those who underwent arthroscopic surgery were referred to as AL. Comparison was made between the two methods of operation. The statistical analysis was done with RevMan 5.3. The analysis included Visual Analogue Scale (VAS) scores and postoperative wound infections. A total of six studies were included for analysis under inclusion and exclusion criteria. There were 798 patients, 476 was AL group and 322 was OL group. No statistical significance was found on the incidence of postoperative wound infection in the patients who underwent the Latarjet procedure (odds ratio [OR], 1.43; 95% confidence interval [CI], 0.28-7.31; p = 0.67) and the VAS score after surgery (mean difference [MD], 0.70; 95% CI, -0.67 to 2.06; p = 0.32) for patients. However, it has now been demonstrated that arthroscopy is a safe and viable alternative. The only drawback of arthroscopic Latarjet surgery is probably that it has a long learning curve and requires a lot of practice from the surgeon.
拉塔热手术是治疗肩关节前脱位患者公认的手术方法。然而，随着关节镜检查越来越普及，越来越多的患者采用微创技术治疗肩关节前脱位。本研究旨在比较关节镜下拉塔热手术（AL）和开放拉塔热手术（OL）治疗肩关节前脱位的疗效。我们的假设是，关节镜手术的效果优于开放手术。研究期间，对包括EMBASE和Cochrane图书馆在内的四个主要数据库进行了检索。纳入了六项比较AL和OL治疗肩关节前脱位的队列研究。截至2023年采用开放技术手术的患者称为OL组，接受关节镜手术的患者称为AL组。对两种手术方法进行了比较。采用RevMan 5.3进行统计分析。分析内容包括视觉模拟评分（VAS）和术后伤口感染情况。共有六项研究符合纳入和排除标准并纳入分析。患者共798例，其中AL组476例，OL组322例。接受拉塔热手术的患者术后伤口感染发生率（比值比[OR]，1.43；95%置信区间[CI]，0.28 - 7.31；p = 0.67）和术后VAS评分（平均差值[MD]，0.70；95% CI，-0.67至2.06；p = 0.32）差异均无统计学意义。然而，现已证明关节镜检查是一种安全可行的替代方法。关节镜下拉塔热手术的唯一缺点可能是学习曲线较长，需要外科医生大量的实践操作。
