• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Arthroscopic Anatomic Glenoid Reconstruction: Analysis of the Learning Curve
【24h】

Arthroscopic Anatomic Glenoid Reconstruction: Analysis of the Learning Curve

机译：关节镜解剖性关节盂重建：学习曲线分析

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Anatomic glenoid reconstruction involves the use of distal tibial allograft for bony augmentation of the glenoid surface. An all-arthroscopic approach was recently described to avoid damage to the subscapularis tendon and preserve the capsule and labrum. Purpose: To explore and compare change in surgical time between 2 proposed methods used for the treatment of anterior shoulder instability—arthroscopic anatomic glenoid reconstruction (AAGR) and arthroscopic Latarjet (AL)—over successive procedures. We also compared graft positioning on the anterior glenoid surface between the 2 methods. Study Design: Cohort study; Level of evidence, 3. Methods: This was a single-surgeon retrospective review of 54 cases of surgically treated recurrent anterior shoulder instability: 27 had AAGR with distal tibial allograft, while the other 27 had AL. AAGR with the distal tibial allograft was the primary choice for the treatment of anterior shoulder instability; however, AL was performed when tibial allograft was not available from the bone bank. Thus, there was an overlapping period for those 2 procedures. Procedure start and end times were recorded, and duration was calculated. Postoperative 3-dimensional computed tomography scans were reviewed, and graft position was judged to be in the lower third (desired position), middle third, or upper third of the anterior glenoid surface. To assess learning, these data were organized in chronological order of surgery, and each surgical cohort was divided into 3 chronological clusters of 9 patients each. Learning was assessed through change in operative time over successive clusters, change in variability of operative time among clusters, and change in graft positioning among clusters. Statistical analysis comprised a 2-tailed independent-sample t test and the Levene test for equality of variance. Results: Our study found that AAGR was significantly faster to perform than AL in the early ( P = .001), middle ( P = .001), and late ( P = .05) clusters of each cohort. Duration of surgery did not significantly improve across clusters within each cohort ( P = .15-.79). There were no significant changes in the variability of surgical time in the AAGR group ( P = .09) or the AL group ( P = .13). Desired positioning of the bone graft on the anterior glenoid surface (lower third) was identified more commonly in the AAGR cohort. Conclusion: AAGR is faster to learn and perform than AL for the treatment of recurrent anterior shoulder instability with significant glenoid bone loss. The current study found higher rates of desired graft positioning for AAGR clusters.
机译：背景：解剖型关节盂重建术涉及使用胫骨远端同种异体骨移植来增加关节盂表面的骨量。最近描述了一种全关节镜的方法，以避免损坏肩s下肌腱并保留囊和唇。目的：探讨并比较连续手术中两种用于治疗前肩关节不稳的方法之间的手术时间变化，这两种方法分别是：关节镜解剖性关节盂重建术（AAGR）和关节镜Latarjet（AL）。我们还比较了两种方法之间在前盂关节表面的移植物定位。研究设计：队列研究;证据等级，3。方法：这是对54例经手术治疗的复发性前肩不稳患者的单手术回顾性回顾性研究：27例行AAGR胫骨远端同种异体移植，而其他27例行AL。 AAGR与胫骨远端同种异体移植是治疗前肩关节不稳的首选方法。然而，当无法从骨库获得同种异体胫骨时，进行了AL。因此，这两个过程有一个重叠的时期。记录程序的开始和结束时间，并计算持续时间。回顾了术后3D计算机断层扫描，并判断移植物位置在前盂盂表面的下三分之一（所需位置），中三分之一或上三分之一。为了评估学习效果，将这些数据按手术时间顺序进行组织，并将每个手术队列分为3个按时间顺序排列的簇，每组9名患者。通过连续集群的手术时间变化，集群之间的手术时间变异性以及集群之间的移植物位置变化来评估学习情况。统计分析包括2尾独立样本t检验和方差相等的Levene检验。结果：我们的研究发现，在每个队列的早期（P = .001），中部（P = .001）和晚期（P = .05）群集中，AAGR的执行速度明显快于AL。每个队列中各组的手术时间均无明显改善（P = .15-.79）。 AAGR组（P = .09）或AL组（P = .13）的手术时间变异性无明显变化。在AAGR队列中，更常见地将骨移植物定位在前盂盂表面（下三分之一）上。结论：AAGR在复发性前肩关节不稳伴关节盂严重骨丢失的治疗中比AL更快学习和执行。当前的研究发现，AAGR簇的期望移植物定位率更高。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号