Abstract：
BACKGROUND: Management of patients with recurrent anterior glenohumeral instability in the setting of subcritical glenoid bone loss (GBL), defined in this study as 20% GBL or less, remains controversial. This study aimed to compare arthroscopic Bankart with remplissage (ABR+R) to open Latarjet for subcritical GBL in primary or revision procedures. We hypothesized that ABR+R would yield higher rates of recurrent instability and reoperation compared to Latarjet in both primary and revision settings.
METHODS: A retrospective study was conducted on patients undergoing either arthroscopic ABR+R or an open Latarjet procedure. Patients with connective tissue disorders, critical GBL (>20%), < 2 year follow-up, or insufficient data were excluded. Recurrent instability and revision were the primary outcomes of interest. Additional outcomes of interest included subjective shoulder value (SSV), strength and range of motion (ROM) RESULTS: 108 patients (70 ABR+R, 38 Latarjet) were included with an average follow-up of 4.3 ±2.1 years. In the primary and revision settings, similar rates of recurrent instability (Primary: p=0.60; Revision: p=0.28) and reoperation (Primary: p=0.06; Revision: p=1.00) were observed between Latarjet and ABR+R. Primary ABR+R exhibited better SSV, active ROM, and internal rotation strength compared to primary open Latarjet. However, no differences were observed in the revision setting.
CONCLUSIONS: Similar rates of recurrent instability and reoperation in addition to comparable outcomes with no differences in ROM were found for ABR+R and Latarjet in patients with subcritical GBL in both the primary and revision settings. ABR+R can be a safe and effective procedure in appropriately selected patients with less than 20% GBL for both primary and revision stabilization.
METHODS: A retrospective study was conducted on patients undergoing either arthroscopic ABR+R or an open Latarjet procedure. Patients with connective tissue disorders, critical GBL (>20%), < 2 year follow-up, or insufficient data were excluded. Recurrent instability and revision were the primary outcomes of interest. Additional outcomes of interest included subjective shoulder value (SSV), strength and range of motion (ROM) RESULTS: 108 patients (70 ABR+R, 38 Latarjet) were included with an average follow-up of 4.3 ±2.1 years. In the primary and revision settings, similar rates of recurrent instability (Primary: p=0.60; Revision: p=0.28) and reoperation (Primary: p=0.06; Revision: p=1.00) were observed between Latarjet and ABR+R. Primary ABR+R exhibited better SSV, active ROM, and internal rotation strength compared to primary open Latarjet. However, no differences were observed in the revision setting.
CONCLUSIONS: Similar rates of recurrent instability and reoperation in addition to comparable outcomes with no differences in ROM were found for ABR+R and Latarjet in patients with subcritical GBL in both the primary and revision settings. ABR+R can be a safe and effective procedure in appropriately selected patients with less than 20% GBL for both primary and revision stabilization.
摘要：
背景：对亚临界关节盂骨丢失（GBL）的复发性前肱骨不稳患者的治疗，在这项研究中定义为20%GBL或更低，仍然有争议。这项研究旨在比较关节镜Bankart和remplissage（ABRR）在初级或修订程序中打开Latarjet用于亚临界GBL。我们假设在主要和翻修设置中，与Latarjet相比，ABRR会产生更高的复发性不稳定和再手术率。
方法：对接受关节镜ABR+R或开放式Latarjet手术的患者进行了回顾性研究。结缔组织疾病患者，临界GBL（>20%），<2年随访，或数据不足被排除。反复出现的不稳定性和修正是人们感兴趣的主要结果。其他感兴趣的结果包括主观肩值(SSV)，强度和活动范围（ROM）结果：108例患者（70ABRR，38Latarjet）被包括在内，平均随访时间为4.3±2.1年。在主要和修订设置中，在Latarjet和ABR之间观察到类似的复发性不稳定率（主要：p=0.60;修订：p=0.28）和再次手术率（主要：p=0.06;修订：p=1.00）。主要ABR+R表现出更好的SSV，活动ROM，与初级开放式Latarjet相比，内部旋转强度。然而,在修订设置中没有观察到差异.
结论：在初级和翻修设置的亚危重GBL患者中，ABR+R和Latarjet的复发不稳定性和再次手术率相似，但ROM没有差异。ABR+R在适当选择GBL小于20%的患者中对于主要和翻修稳定都是安全有效的程序。
方法：对接受关节镜ABR+R或开放式Latarjet手术的患者进行了回顾性研究。结缔组织疾病患者，临界GBL（>20%），<2年随访，或数据不足被排除。反复出现的不稳定性和修正是人们感兴趣的主要结果。其他感兴趣的结果包括主观肩值(SSV)，强度和活动范围（ROM）结果：108例患者（70ABRR，38Latarjet）被包括在内，平均随访时间为4.3±2.1年。在主要和修订设置中，在Latarjet和ABR之间观察到类似的复发性不稳定率（主要：p=0.60;修订：p=0.28）和再次手术率（主要：p=0.06;修订：p=1.00）。主要ABR+R表现出更好的SSV，活动ROM，与初级开放式Latarjet相比，内部旋转强度。然而,在修订设置中没有观察到差异.
结论：在初级和翻修设置的亚危重GBL患者中，ABR+R和Latarjet的复发不稳定性和再次手术率相似，但ROM没有差异。ABR+R在适当选择GBL小于20%的患者中对于主要和翻修稳定都是安全有效的程序。
