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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Outcomes of the Latarjet procedure for the treatment of chronic anterior shoulder instability: patients with prior arthroscopic Bankart repair versus primary cases
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Outcomes of the Latarjet procedure for the treatment of chronic anterior shoulder instability: patients with prior arthroscopic Bankart repair versus primary cases

机译：Latarjet手术治疗慢性前肩不稳的结果：先前行关节镜行Bankart修复的患者与主要病例

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Objectives The two most common surgical interventions for recurrent anterior shoulder instability include arthroscopic Bankart repair and the Latarjet procedure. However, indications for each procedure remain debated between surgeons with 90% of surgeons (except French surgeons) preferring soft tissue Bankart repair initially. It remains unclear whether the results of a Latarjet procedure performed after a failed arthroscopic Bankart repair differ from those performed for primary cases. The purpose of our study was to compare the postoperative outcomes of patients who had undergone a Latarjet as a primary surgery versus those who had had a Latarjet as revision surgery for a failed arthroscopic Bankart repair Methods Patients who had undergone open or arthroscopic Latarjet procedure between 2003 and 2015 in 5 fellowship-trained surgical practices were included. Charts were retrospectively reviewed to identify patients who had undergone a primary Latarjet or those who had had a Bankart repair prior to the Latarjet. Age, ISIS score, BMI, sports activity, hyperlaxity and delay before surgery were retrospectively collected. Outcome measures were prospectively collected, including range of motion, SSV, Walch-Duplay, scores, recurrence of instability, apprehension or new surgery. Results A total of 311 patients were included. 28% of the patients were lost to follow-up and the mean follow-up was 3.4 years +/-0.8. There were 21 patients who had had a Bankart repair prior to the Latarjet procedure. Both populations were comparable regarding preoperative data. The postoperative instability rate was 3% in the overall population; 4.8% in the “primary Latarjet” group and 2.3% in the ”Latarjet for failed Bankart” group. This difference was not significant (p=0.50). However, the mean Walch-Duplay score was significantly lower and the pain scores significantly higher in patients who had had a prior Bankart repair: 51.9 +/- 25 versus 72.1 +/- 25.2 and 2.5/10 versus 1.2/10 respectively. The Simple Shoulder Test was comparable in both groups. Conclusion The study confirms that the Latarjet is an effective procedure to treat primary chronic anterior instability and also to stabilize a shoulder after a failed Bankart repair. However, the thought that a Bankart repair does not “burn any bridges” appears to be incorrect relative to postoperative pain and functional scores in the setting of future Latarjet procedure.
机译：目的复发性前肩关节不稳的两种最常见的外科手术包括关节镜下Bankart修复和Latarjet手术。然而，对于每个手术的适应症仍在外科医生之间争论不休，其中90％的外科医生（法国外科医生）最初更喜欢使用软组织Bankart修复。尚不清楚关节镜内Bankart修复失败后执行的Latarjet程序的结果是否与主要病例的结果不同。本研究的目的是比较因进行关节镜内Bankart修复失败而接受Latarjet初次手术的患者与接受过Latarjet翻修手术的患者的术后结果。方法2003年之间接受开放式或关节镜下Latarjet手术的患者并在2015年纳入了5个研究金培训的手术方法。回顾性检查图表，以识别接受过Latarjet初次手术或在Latarjet之前行Bankart修复的患者。回顾性收集年龄，ISIS评分，BMI，运动活动，过度放松和手术延迟。前瞻性收集了结果指标，包括运动范围，SSV，Walch-Duplay，评分，不稳定因素复发，忧虑或新手术。结果共纳入311例患者。 28％的患者失去随访，平均随访时间为3.4年+/- 0.8。在进行Latarjet手术之前，有21位患者进行了Bankart修复。就术前数据而言，两个人群具有可比性。总体人群的术后不稳定率为3％; “主要的Latarjet”组为4.8％，“失败的Bankart”组为2.3％。该差异不显着（p ＝ 0.50）。但是，先前行过Bankart修复的患者的平均Walch-Duplay得分明显更低，而疼痛得分则明显更高：分别为51.9 +/- 25对72.1 +/- 25.2和2.5 / 10对1.2 / 10。两组的简单肩部测试相当。结论该研究证实Latarjet是治疗原发性慢性前路不稳并在Bankart修复失败后稳定肩膀的有效方法。但是，在将来的Latarjet手术中，相对于术后疼痛和功能评分，Bankart修复不会“烧掉任何牙桥”的想法似乎是不正确的。

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