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特里拉特手术:并发症与结果的系统评价

The Trillat procedure: a systematic review of complications and outcome.

作者信息

Secci Gregorio, Schippers Philipp, Biégun Manon, Mouchantaf Mark, Boileau Pascal

机构信息

Istitut de Chirurgie Réparatrice (ICR) Locomoteur & Sports, Groupe KANTYS, Nice, France.

Department of Shoulder Surgery, AOU Careggi, University Hospital of Florence, Florence, Italy.

出版信息

JSES Rev Rep Tech. 2024 Jul 20;4(4):694-702. doi: 10.1016/j.xrrt.2024.06.011. eCollection 2024 Nov.

Abstract

BACKGROUND

The Trillat procedure is a surgical treatment for recurrent anterior shoulder instability. It consists of an inferior closed-wedge osteoclasy of the coracoid process. Nowadays, it is used to treat selected cases of shoulder instability. This systematic review aims to provide an overview of clinical and functional outcomes, recurrence rate, and complications of the Trillat procedure for recurrent anterior shoulder instability.

METHODS

A systematic review of the literature regarding the Trillat procedure for recurrent anterior shoulder instability was carried out on Medline, through PubMed, and Embase. The English and French literature published before the 4 of November 2023 was analyzed. The data regarding demographics, outcome, recurrency, and complications were reported.

RESULTS

From 38 articles with the primary search, seven manuscripts were enrolled. A total of 419 patients and 443 shoulders were analyzed, with a mean age of 35.46 (range 25-61) years. The mean follow-up was 65.01 (range 24.8-132) months postoperative. The pooled data showed 91.2% of subjective satisfaction, weighted mean postoperative Rowe score of 86.25 points, Walch-Duplay of 84.6 points, and a Constant-Murley Score of 84.82 points. The recurrence rate was 10.28% for all the articles involved and 8.51% for the articles proposing the procedure for selected case of anterior instability, with low-grade glenoid bone loss. The most common complications were a loss of external rotation and the development of osteoarthritis.

CONCLUSION

The Trillat procedure for recurrent anterior shoulder instability showed promising results, especially in selected cases, such as low-grade glenoid bone loss, with massive irreparable cuff tears or hyperlaxity.

摘要

背景

特里拉特手术是一种治疗复发性肩关节前脱位的外科手术。它包括喙突下闭合楔形截骨术。如今,该手术用于治疗特定的肩关节不稳定病例。本系统评价旨在概述特里拉特手术治疗复发性肩关节前脱位的临床和功能结果、复发率及并发症。

方法

通过PubMed和Embase在Medline上对有关特里拉特手术治疗复发性肩关节前脱位的文献进行系统评价。分析了2023年11月4日前发表的英文和法文文献。报告了有关人口统计学、结果、复发和并发症的数据。

结果

在初步检索的38篇文章中,纳入了7篇手稿。共分析了419例患者和443个肩关节,平均年龄为35.46岁(范围25 - 61岁)。术后平均随访时间为65.01个月(范围24.8 - 132个月)。汇总数据显示主观满意度为91.2%,术后加权平均Rowe评分为86.25分,Walch - Duplay评分为84.6分,Constant - Murley评分为84.82分。所有纳入文章的复发率为10.28%,对于针对伴有轻度肩胛盂骨质流失的前脱位特定病例采用该手术的文章,复发率为8.51%。最常见的并发症是外旋丧失和骨关节炎的发展。

结论

特里拉特手术治疗复发性肩关节前脱位显示出有前景的结果,特别是在特定病例中,如轻度肩胛盂骨质流失、伴有巨大不可修复的肩袖撕裂或关节过度松弛的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/11514100/17395ef4665b/gr1.jpg

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