■开发了Latarjet程序,用于治疗年轻的肩关节前不稳定,高需求的磨耗性关节盂骨丢失患者,其初级位错后再位错的风险可能超过90%。在手术后重新出现的患者的晚期计算机断层扫描(CT)扫描中通常会观察到喙突移植物骨质溶解和突出的螺钉,但在整个Latarjet队列中骨质溶解的临床相关性尚未确定.我们旨在评估接受Latarjet手术的患者的临床和放射学结果,并确定严重的喙突移植物骨溶解是否损害了临床结果。
■这是对接受开放式Latarjet手术的患者的回顾性分析。通过包含西安大略肩关节不稳定指数(WOSI)的电子问卷邀请患者,并询问了索引手术以来的再脱位和再手术。使用最佳拟合圆法在CT上计算术前关节盂骨丢失。骨溶解分别在近端和远端螺钉的水平上进行分级(0,螺钉头埋在移植物中;1,螺钉头暴露;2,螺纹暴露;3,完全吸收/严重骨溶解)。术后≥12个月进行轴向CT扫描。
■在2011年至2022年之间,一名外科医生进行了442Latarjet手术。158名患者在术后44(27-70)个月的中位数(四分位距[IQR])回答了问卷,其中中位数(IQR)WOSI评分为352(142-666)分(0=最佳,2100=最差)。3/158(2%)患者发生复发性前不稳。一名患者为此适应症需要再次手术。在术后CT扫描≥12个月(中位数[IQR]40[29-69]个月)的患者中,1例患者在两个螺钉周围出现严重的骨质溶解(WOSI=90),17/62(27%)患者在1个螺钉周围出现严重的骨溶解,所有这些都是近端(中位数[IQR]WOSI=235[135-644]),44/62(71%)患者在任一螺钉周围均未出现严重骨质溶解(中位数[IQR]WOSI=487[177-815]).基于严重骨质溶解的存在,两组之间的WOSI评分没有统计学上的显着差异。
■Latarjet是可靠的程序,其再脱位和再手术率低。随着时间的推移,喙突移植物会出现严重的骨质溶解,并且总是首先影响近端移植物。严重骨质溶解的存在并不影响临床结果。
UNASSIGNED: The Latarjet procedure was developed for the treatment of anterior shoulder instability in young, high-demand patients with attritional glenoid bone loss, whose risk of redislocation following primary dislocation may exceed 90%. Coracoid graft
osteolysis and prominent screws are commonly observed in late computed tomography (CT) scans of patients who re-present following the procedure, but the clinical relevance of
osteolysis in the overall Latarjet cohort is undetermined. We aimed to evaluate clinical and radiological outcomes in patients who underwent the Latarjet procedure, and to determine if severe coracoid graft osteolysis compromised clinical outcomes.
UNASSIGNED: This was a retrospective analysis of patients who underwent the open Latarjet procedure. Patients were invited via an e-questionnaire that contained a Western Ontario Shoulder Instability Index (WOSI), and queried about redislocation and reoperation since index surgery. Preoperative glenoid bone loss was calculated on CT using the best-fit circle method. Osteolysis was graded (0, screw head buried in graft; 1, screw head exposed; 2, threads exposed; 3, complete resorption/severe
osteolysis) at the level of the proximal and distal screws respectively, on axial CT scans performed ≥ 12 months postoperatively.
UNASSIGNED: Between 2011 and 2022, a single surgeon performed 442 Latarjet procedures. One hundred fifty eight patients responded to the questionnaire at median (interquartile range [IQR]) 44 (27-70) months postoperatively, among whom the median (IQR) WOSI score was 352 (142-666) points (0 = best, 2100 = worst). Recurrent anterior instability occurred in 3/158 (2%) patients. One patient required reoperation for this indication. Among patients who had CT scans ≥ 12 months postoperatively (median [IQR] 40 [29-69] months), 1 patient developed severe osteolysis around both screws (WOSI = 90), 17/62 (27%) patients developed severe osteolysis around 1 screw, all of which were proximal (median [IQR] WOSI = 235 [135-644]), and 44/62 (71%) patients did not develop severe osteolysis around either screw (median [IQR] WOSI = 487 [177-815]). There were no statistically significant differences in WOSI scores between groups based on the presence of severe osteolysis.
UNASSIGNED: The Latarjet is reliable procedure that has a low rate of redislocation and reoperation. Severe coracoid graft
osteolysis occurs with time, and always affects the proximal graft first. The presence of severe
osteolysis did not compromise clinical outcomes.