Nair Vinod, Muneer Mohammed Talha, Chowdhary Sahil
Orthopedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus. 2024 Aug 27;16(8):e67908. doi: 10.7759/cureus.67908. eCollection 2024 Aug.
The Latarjet procedure is a well-established technique for managing repeated anterior shoulder dislocation accompanied by massive glenoid bone loss. Aim of this article was to assess outcomes among modified Latarjet procedure using allograft from Iliac bone and a standard Latarjet procedure using the coracoid process.
Six patients with recurrent anterior shoulder instability and significant glenoid bone loss were retrospectively analyzed. Three patients underwent the modified Latarjet procedure with iliac crest bone graft (Group A), and three underwent the standard Latarjet procedure (Group B). Outcomes were assessed at the 12-month follow-up, including shoulder stability, functional scores (Constant, the American Shoulder and Elbow Surgeons (ASES) score, and the Western Ontario Shoulder Instability Index (WOSI)), range of motion, complications, and return to sports.
Both groups showed improvements in stability and functional scores, with no recurrent instability reported. Group A demonstrated slightly higher functional scores and range of motion. One patient in Group A experienced donor site pain, while one patient in Group B showed significant graft resorption. Graft union was achieved in all patients. Two-thirds of patients in each group returned to their pre-injury level of sports participation.
Both techniques provided good clinical outcomes for anterior shoulder instability with glenoid bone loss. The modified Latarjet with iliac crest graft may offer slight advantages in functional outcomes and graft preservation but is associated with potential donor site morbidity. Larger, prospective studies are needed to definitively compare these techniques.
Latarjet手术是一种成熟的技术,用于治疗伴有严重肩胛盂骨丢失的复发性肩关节前脱位。本文的目的是评估使用髂骨同种异体移植物的改良Latarjet手术与使用喙突的标准Latarjet手术的疗效。
回顾性分析6例复发性肩关节前不稳定伴严重肩胛盂骨丢失的患者。3例患者接受了带髂嵴骨移植的改良Latarjet手术(A组),3例接受了标准Latarjet手术(B组)。在12个月的随访中评估疗效,包括肩关节稳定性、功能评分(Constant评分、美国肩肘外科医师学会(ASES)评分和西安大略肩关节不稳定指数(WOSI))、活动范围、并发症和恢复运动情况。
两组的稳定性和功能评分均有改善,均未报告复发性不稳定。A组的功能评分和活动范围略高。A组1例患者出现供区疼痛,B组1例患者出现明显的移植物吸收。所有患者的移植物均愈合。每组三分之二的患者恢复到受伤前的运动参与水平。
两种技术对于伴有肩胛盂骨丢失的肩关节前不稳定均提供了良好的临床疗效。带髂嵴移植的改良Latarjet手术在功能疗效和移植物保留方面可能略有优势,但与潜在的供区并发症相关。需要更大规模的前瞻性研究来明确比较这些技术。