Hoshika Shota, Matsuki Keisuke, Takahashi Norimasa, Sugaya Hiroyuki
Shoulder & Elbow Service, Funabashi Orthopaedic Sports Medicine & Joint Center, Funabashi, Chiba, Japan.
Tokyo Sports & Orthopaedic Clinic, Toshimaku, Tokyo, Japan.
JSES Int. 2025 Jan 27;9(3):619-624. doi: 10.1016/j.jseint.2024.12.019. eCollection 2025 May.
The coracoid process transfer, such as the Bristow or Latarjet procedure, is standard procedure for cases of anterior shoulder instability with large bone defects. However, the revision surgery for failed coracoid transfer was challenging. The purpose of this study was to retrospectively assess the clinical outcomes after arthroscopic soft-tissue stabilization for failed coracoid transfer.
This retrospective study assessed patients who underwent arthroscopic soft-tissue shoulder stabilization for failed coracoid transfer at our institute between January 2008 and December 2021 with at least 2 years of follow-up. Patients' demographics, radiographic findings, intraoperative findings, clinical outcomes (Rowe scores, Subjective Shoulder Value, and the visual analog scale for pain), and return to play sports were investigated.
This study included fifteen shoulders in fifteen patients (14 males and 1 female) with a mean age of 30 years (range, 18-51 years). Fourteen (93%) patients participated in sports activities. The average time between the initial and revision surgeries was 107 months (range, 24-360 months) with a follow-up of 46 months (range, 24-120 months). Preoperative computed tomographic showed graft nonunion in nine (60%) shoulders, graft malposition in five (33%) shoulders, and hardware complications in five (33%) shoulders. Intraoperative findings demonstrated an unrepaired Bankart lesion in 14 (93%) patients and a capsular tear in one (7%) patient. Rowe score, Subjective Shoulder Value, and pain visual analog scale significantly improved postoperatively ( < .001 for each). Twelve of 14 patients (86%) returned to sports activity at a complete or near-preinjury level. One (7%) patient experienced redislocation that required revision surgery and two (13%) experienced axial nerve palsy.
All shoulders with failed coracoid transfer had an unrepaired Bankart lesion except one shoulder with a capsular tear. Arthroscopic soft-tissue stabilization combined with selective augmentations yielded good clinical outcomes, demonstrated by a low recurrence rate, high return to play sports rate, and good shoulder function.
喙突转移术，如布里斯托（Bristow）或拉塔热（Latarjet）手术，是治疗伴有大骨缺损的前肩不稳病例的标准手术。然而，喙突转移失败后的翻修手术具有挑战性。本研究的目的是回顾性评估关节镜下软组织稳定术治疗喙突转移失败后的临床疗效。
这项回顾性研究评估了2008年1月至2021年12月期间在我院接受关节镜下软组织肩关节稳定术治疗喙突转移失败且随访至少2年的患者。调查了患者的人口统计学资料、影像学检查结果、术中发现、临床疗效（罗伊（Rowe）评分、主观肩关节评分和疼痛视觉模拟量表）以及恢复运动情况。
本研究纳入了15例患者的15个肩关节（14例男性和1例女性），平均年龄30岁（范围18 - 51岁）。14例（93%）患者参与体育活动。初次手术与翻修手术之间的平均时间为107个月（范围24 - 360个月），随访时间为46个月（范围24 - 120个月）。术前计算机断层扫描显示9个（60%）肩关节存在移植物不愈合，5个（33%）肩关节存在移植物位置不当，5个（33%）肩关节存在硬件并发症。术中发现14例（93%）患者存在未修复的肩胛下肌前盂唇损伤，1例（7%）患者存在关节囊撕裂。罗伊评分、主观肩关节评分和疼痛视觉模拟量表术后均显著改善（每项均P < .001）。14例患者中有12例（86%）恢复到完全或接近受伤前水平的体育活动。1例（7%）患者出现再脱位需要翻修手术，2例（13%）患者出现腋神经麻痹。
除1例有关节囊撕裂的肩关节外，所有喙突转移失败的肩关节均存在未修复的肩胛下肌前盂唇损伤。关节镜下软组织稳定术联合选择性增强术产生了良好的临床疗效表现为低复发率、高恢复运动率和良好的肩关节功能。
