Steadman Philippon Research Institute, Vail, Colorado.
Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A.
Arthroscopy. 2024 Apr;40(4):1311-1324.e1. doi: 10.1016/j.arthro.2023.09.032. Epub 2023 Oct 11.
To analyze radiographic outcomes by conventional radiography, computed tomography (CT), or both and complication rates of open coracoid transfer at a minimum of 12-months follow-up.
A literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PubMed, Medline (Ovid), and EMBASE library databases. Inclusion criteria were clinical studies reporting on open Latarjet as the primary surgical procedure(revision coracoid transfer after failed prior stabilization excluded) with postoperative radiographic outcomes at a minimum mean 1-year follow-up. Patient demographics, type of postoperative imaging modality, and radiographic outcomes and complications including graft union, osteoarthritis, and osteolysis were systematically reviewed. Data were summarized as ranges of reported values for each outcome metric. Each radiographic outcome was graphically represented in a Forest plot with point estimates of the incidence of radiographic outcomes with corresponding 95% confidence intervals and I.
Thirty-three studies met inclusion criteria, with a total of 1,456 shoulders. The most common postoperative imaging modality was plain radiography only (n = 848 [58.2%]), both CT and radiography (n = 287 [19.7%]), and CT only (n = 321 [22.1%]). Overall, the reported graft union rate ranged from 75% to 100%, of which 79.8% (n = 395) were detected on plain radiography. The most common reported postoperative radiographic complications after the open coracoid transfer were osteoarthritis (range, 0%-100%, pooled mean 28%), graft osteolysis (range, 0%-100%, pooled mean 30%), nonunion (range, 0%-32%, pooled mean 5.1%), malpositioned graft (range, 0%-75%, pooled mean 14.75%), hardware issues (range, 0%-9.1%, pooled mean 5%), and bone block fracture (range, 0%-8%, pooled mean 2.1%). Graft healing was achieved in a majority of cases (range, 75%-100%).
Postoperative radiographic outcomes after open coracoid transfer vary greatly in definition, classification, and imaging modality of choice. Greater consistency in postoperative radiographic outcomes is essential to evaluate graft healing, osteolysis, and nonunion.
Level IV, systematic review of Level III-IV studies.
通过常规 X 线摄影、计算机断层扫描（CT）或两者对开放性喙突转移术的放射学结果进行分析，并在至少 12 个月的随访时评估并发症发生率。
根据系统评价和荟萃分析的首选报告项目指南，使用 PubMed、Medline（Ovid）和 EMBASE 库数据库进行文献检索。纳入标准为：临床研究报告开放性 Latarjet 作为主要手术（排除先前固定失败后的修正喙突转移），术后放射学结果至少在 1 年的平均随访期。对患者人口统计学、术后成像方式以及包括移植物愈合、骨关节炎和骨溶解在内的放射学结果和并发症进行系统评价。数据汇总为每个结果指标报告值的范围。每个放射学结果均以森林图形式表示，以点估计表示放射学结果的发生率，以及相应的 95%置信区间和 I²值。
33 项研究符合纳入标准，共纳入 1456 例肩关节。最常见的术后影像学检查方式为仅行 X 线摄影（n=848[58.2%]）、CT 和 X 线摄影联合（n=287[19.7%]）和仅行 CT（n=321[22.1%]）。总体而言，报道的移植物愈合率范围为 75%至 100%，其中 79.8%（n=395）在 X 线摄影上发现。开放性喙突转移术后最常见的报告放射学并发症是骨关节炎（范围 0%至 100%，汇总平均 28%）、移植物骨溶解（范围 0%至 100%，汇总平均 30%）、骨不连（范围 0%至 32%，汇总平均 5.1%）、移植物位置不当（范围 0%至 75%，汇总平均 14.75%）、内固定问题（范围 0%至 9.1%，汇总平均 5%）和骨块骨折（范围 0%至 8%，汇总平均 2.1%）。大多数情况下（范围 75%至 100%）可实现移植物愈合。
开放性喙突转移术后的放射学结果在定义、分类和选择的影像学方式上存在很大差异。术后放射学结果的一致性对于评估移植物愈合、骨溶解和骨不连至关重要。
IV 级，对 III-IV 级研究的系统评价。
