在至少2年的随访中，对于关节盂骨量丢失10%-20%的患者，初次Latarjet手术与初次关节镜下Bankart修复术后患者报告的结果相似，但再脱位率较低，翻修率较高。
Similar patient-reported outcomes but lower redislocation and higher revision rates following primary Latarjet vs. primary arthroscopic Bankart repair in patients with 10%-20% glenoid bone loss at a minimum 2-year follow-up.
作者信息
van Spanning Sanne H, Verweij Lukas P E, Geervliet Pieter C, van den Borne Maaike P J, van den Bekerom Michel P J, Benner Joyce L
机构信息
Shoulder and Elbow Unit, Joint Research, Department of Orthopaedic Surgery, OLVG, Amsterdam, the Netherlands; Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, the Netherlands; Department of Orthopaedic Surgery, CORAL Centre for Orthopaedic Research Alkmaar, Northwest Clinics, Alkmaar, the Netherlands.
Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, the Netherlands; Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Musculoskeletal Health Program, Amsterdam, the Netherlands.
出版信息
J Shoulder Elbow Surg. 2025 Feb 1. doi: 10.1016/j.jse.2024.12.020.
BACKGROUND
The amount of glenoid bone loss is closely related to the success rate of surgical treatment following anterior shoulder dislocations. There is an ongoing debate on the most successful treatment in patients with a subcritical amount (10%-20%) of glenoid bone loss (GBL). This study aimed to compare patient-reported outcome measures (PROMs) following primary open Latarjet procedure and primary arthroscopic Bankart repair (ABR) in patients with 10%-20% GBL at a minimum 2-year follow-up.
METHODS
This multicenter retrospective cohort study included 53 patients with traumatic anterior shoulder dislocations treated with Latarjet or ABR between 2011 and 2019. PROMs included the Western Ontario Shoulder Instability Index (WOSI) and Oxford Shoulder Instability Score (OSIS). Secondary outcomes included recurrence, complications, revision surgery, patient satisfaction, and return to sport (RTS).
RESULTS
The mean follow-up was 77 ± 31.7 months. Baseline characteristics were similar between ABR and Latarjet, except for time to follow-up (91 ± 30 vs. 61 ± 26 months, P < .001) and percentage GBL (15 ± 3 vs. 17 ± 3, P = .024). WOSI scores were higher in Latarjet patients compared with ABR; however, this difference was not statistically significant (220 vs. 457, P = .10). OSIS scores were similar following ABR and Latarjet (42 vs. 45, P = .33). Recurrence rates were higher in ABR patients (7 [24%] vs. 0 [0%] recurrences, P = .01), whereas revision rates were higher in Latarjet patients (4 vs. 0 revisions, P = .04). Patient satisfaction and complications were not different between the 2 procedures and neither achieved RTS and RTS to preinjury level.
CONCLUSION
The null hypothesis in which Latarjet and ABR show similar patient-reported outcomes could not be rejected based on the underpowered analysis. Patients treated with Latarjet did not have any recurrences vs. 7 in the ABR group (P = .01). However, revision rates were higher in Latarjet patients (4 vs. 0 revisions, P = .04).
背景
肩胛盂骨丢失量与前肩脱位后手术治疗的成功率密切相关。对于肩胛盂骨丢失量处于临界以下水平（10%-20%）的患者，哪种治疗方法最为成功仍存在争议。本研究旨在比较初次开放性Latarjet手术和初次关节镜下Bankart修复术（ABR）治疗肩胛盂骨丢失量为10%-20%的患者至少2年随访后的患者报告结局指标（PROMs）。
方法
这项多中心回顾性队列研究纳入了2011年至2019年间接受Latarjet手术或ABR治疗的53例创伤性前肩脱位患者。PROMs包括西安大略肩不稳定指数（WOSI）和牛津肩不稳定评分（OSIS）。次要结局指标包括复发、并发症、翻修手术、患者满意度和恢复运动（RTS）。
结果
平均随访时间为77±31.7个月。ABR组和Latarjet组的基线特征相似，但随访时间（91±30个月 vs. 61±26个月，P<.001）和肩胛盂骨丢失百分比（15±3% vs. 17±3%，P=.024）除外。Latarjet组患者的WOSI评分高于ABR组；然而，这种差异无统计学意义（220 vs. 457，P=.10）。ABR组和Latarjet组术后OSIS评分相似（42 vs. 45，P=.33）。ABR组患者的复发率更高（7例[24%]复发 vs. 0例[0%]复发，P=.01），而Latarjet组患者的翻修率更高（4例翻修 vs. 0例翻修，P=.04）。两种手术方法在患者满意度和并发症方面无差异，且均未达到恢复运动及恢复至伤前运动水平。
结论
基于效能不足的分析，无法拒绝Latarjet手术和ABR手术在患者报告结局方面相似的原假设。接受Latarjet手术治疗的患者无复发，而ABR组有7例复发（P=.01）。然而，Latarjet组患者的翻修率更高（4例翻修 vs. 0例翻修，P=.04）。
Zotero 插件