背景:肩膀本体感受,肱骨前囊在其中起主要作用,对肩膀的功能至关重要。因此,大多数外科医生在肩关节稳定手术中不切除或重新插入前囊。在最初的开放式Latarjet程序(OLP)中,前囊被保留。然而,在全关节镜Latarjet手术(ALP)中,建议进行完整的前囊切除术,以获得更好的视野和进入喙突。这提出了一个问题,即这两种程序之间是否存在术后本体感觉差异。因此,这项研究的目的是(1)评估OLP和ALP后手术侧和健康侧之间的术后本体感觉的差异,(2)比较OLP和ALP在手术侧的术后本体感觉的差异。
方法:我们进行了一项回顾性分析,包括在我们中心进行OLP或ALP后进行本体感觉测试的所有患者。收集的基线特征包括性别,手术年龄,操作侧,手支配,有Hill-Sachs病变,手术和本体感觉测试之间的时间.对于测试,患者被安置在离墙壁1米的地方。他们被蒙住了眼睛,不得不用激光指针贴在食指上指向目标。标记激光点,并水平和垂直测量误差,并归类为<4厘米,4-8厘米,8-16厘米,>16厘米。
结果:在2022年4月至2024年4月之间,确定了91例,其中24例接受了OLP,67例接受了ALP。在两个OLP之后,健康侧和手术侧之间的误差分布没有发现显着差异(水平p=0.30,p=0.67垂直)和ALP(p=0.20水平,p=0.34垂直)。此外,OLP与ALP后操作侧之间的误差分布没有显着差异(P=0.52水平,p=0.61垂直)。
结论:我们的数据表明,OLP和ALP后,手术侧和健康侧的术后本体感觉没有显着差异,OLP后与ALP后的手术侧之间也没有。这可能意味着完全切除前盂肱囊不会对肩部本体感觉产生不利影响。然而,这些结果是多因素和前瞻性研究,需要更好地了解肱骨囊机械感受器的再生潜力和前囊对肩关节本体感觉的重要性。
BACKGROUND: Shoulder proprioception, in which the anterior glenohumeral capsule plays a major role, is critical to the functioning of the shoulder. Consequently, most surgeons either do not resect or reinsert the anterior capsule in shoulder stabilization surgery. In the original Open Latarjet Procedure (OLP), the anterior capsule is preserved. However, in the all-Arthroscopic Latarjet Procedure (ALP), complete anterior capsule resection is recommended for better view and access to the coracoid. This raises the question if there is a postoperative difference in proprioception between these two procedures. Therefore, the aims of this study are (1) to assess the difference in postoperative proprioception between the operated and healthy sides after the OLP and ALP, and (2) to compare the difference in postoperative proprioception on the operated side between the OLP and ALP.
METHODS: We conducted a retrospective analysis including all patients who underwent a proprioception test after an OLP or ALP at our center. Collected baseline characteristics included sex, age at surgery, operated side, hand dominance, presence of a Hill-sachs lesion, and time between surgery and the proprioception test. For the test, patients were positioned 1 meter from a wall. They were blindfolded and had to point at a target with a laser pointer taped to their index finger. The laser point was marked and the errors were measured horizontally and vertically and categorized as < 4 centimeters, 4-8 centimeters, 8-16 centimeters, and >16 centimeters.
RESULTS: Between April 2022 and April 2024, 91 cases were identified, of which 24 underwent an OLP and 67 underwent an ALP. No significant difference was found in error distribution between the healthy and operated side after both the OLP (p = 0.30 horizontally, p = 0.67 vertically) and ALP (p = 0.20 horizontally, p = 0.34 vertically). Moreover, there was no significant difference in error distribution between the operated sides after the OLP versus ALP (p= 0.52 horizontally, p = 0.61 vertically).
CONCLUSIONS: Our data suggests that postoperative proprioception is not significantly different between the operated and healthy sides after both the OLP and ALP, nor between the operated sides after the OLP versus after the ALP. This might imply that completely resecting the anterior glenohumeral capsule does not have a detrimental effect on shoulder proprioception. However, these results are multifactorial and prospective studies are needed to better understand the regeneration potential of glenohumeral capsule mechanoreceptors and the importance of the anterior capsule for shoulder proprioception.