当前位置: X-MOL 学术Am. J. Sports Med. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Are Patients Who Undergo the Latarjet Procedure Ready to Return to Play at 6 Months? A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group Cohort Study.
The American Journal of Sports Medicine ( IF 4.8 ) Pub Date : 2020-02-11 , DOI: 10.1177/0363546520901538
Travis L Frantz 1 , Joshua S Everhart 1 , Gregory L Cvetanovich 1 , Andrew Neviaser 1 , Grant L Jones 1 , Carolyn M Hettrich 1 , Brian R Wolf 1 , 1 , Keith M Baumgarten 1 , Matthew J Bollier 1 , Jonathan T Bravman 1 , John E Kuhn 1 , C Benjamin Ma 1 , Robert G Marx 1 , Eric C McCarty 1 , Shannon F Ortiz 1 , Alan L Zhang 1 , Julie Y Bishop 1
Affiliation  

BACKGROUND The Latarjet procedure is growing in popularity for treating athletes with recurrent anterior shoulder instability, largely because of the high recurrence rate of arthroscopic stabilization, particularly among contact athletes with bone loss. PURPOSE (1) To evaluate return of strength and range of motion (ROM) 6 months after the Latarjet procedure and (2) to determine risk factors for failure to achieve return-to-play (RTP) criteria at 6 months. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS A total of 65 athletes (83% contact sports, 37% overhead sports; mean ± SD age, 24.5 ± 8.2 years; 59 male, 6 female) who enrolled in a prospective multicenter study underwent the Latarjet procedure for anterior instability (29% as primary procedure for instability, 71% for failed prior stabilization procedure). Strength and ROM were assessed preoperatively and 6 months after surgery. RTP criteria were defined as return to baseline strength and <20° side-to-side ROM deficits in all planes. The independent likelihood of achieving strength and motion RTP criteria at 6 months was assessed through multivariate logistic regression modeling with adjustment as needed for age, sex, subscapularis split versus tenotomy, preoperative strength/motion, percentage bone loss, number of prior dislocations, preoperative subjective shoulder function (American Shoulder and Elbow Surgeons and Western Ontario Shoulder Instability Index percentage), and participation in contact versus overhead sports. RESULTS Of the patients, 55% failed to meet ≥1 RTP criteria: 6% failed for persistent weakness and 51% for ≥20° side-to-side loss of motion. There was no difference in failure to achieve RTP criteria at 6 months between subscapularis split (57%) versus tenotomy (47%) (P = .49). Independent risk factors for failure to achieve either strength or ROM criteria were preoperative American Shoulder and Elbow Surgeons scores (per 10-point decrease: adjusted odds ratio [aOR], 1.61; 95% CI, 1.14-2.43; P = .006), Western Ontario Shoulder Instability Index percentage (per 10% decrease: aOR, 0.61; 95% CI, 0.38-0.92; P = .01), and a preoperative side-to-side ROM deficit ≥20° in any plane (aOR, 5.01; 95% CI, 1.42-21.5; P = .01) or deficits in external rotation at 90° of abduction (per 10° increased deficit: aOR, 1.64; 95% CI, 1.06-2.88; P = .02). CONCLUSION A large percentage of athletes fail to achieve full strength and ROM 6 months after the Latarjet procedure. Greater preoperative stiffness and subjective disability are risk factors for failure to meet ROM or strength RTP criteria.

中文翻译:

接受Latarjet手术的患者是否准备在6个月后重返比赛?多中心骨科结果网络(MOON)肩部群组队列研究。

背景技术Latarjet手术在治疗患有复发性前肩不稳的运动员中正变得越来越普遍,这主要是因为关节镜稳定的高复发率,特别是在有骨丢失的接触运动员中。目的(1)评估Latarjet手术后6个月的力量恢复和运动范围(ROM),以及(2)确定6个月未能达到游戏重现(RTP)标准的风险因素。研究设计病例对照研究;证据等级,3。方法参加一项前瞻性多中心研究的65名运动员(83%接触运动,37%间接运动;平均±SD年龄,24.5±8.2岁; 59名男性,6名女性)接受了Latarjet程序对于前部不稳定性(29%作为主要的不稳定方法,对于不成功的先前稳定方法为71%)。术前和术后6个月评估力量和ROM。RTP标准定义为在所有平面中恢复到基线强度和<20°左右ROM缺陷。通过多变量logistic回归模型评估了在6个月时达到力量和运动RTP标准的独立可能性,并根据年龄,性别,肩sub下裂与腱切开术,术前力量/运动,骨丢失百分比,先前脱位的数量,术前主观的需要进行了调整肩部功能(美国肩膀和肘部外科医师和西安大略省肩膀不稳定性指数所占百分比),以及参与接触式运动与高架运动的参与度。结果在这些患者中,有55%的患者未达到RTP≥1标准:6%的患者因持续虚弱而失败,而51%的患者≥20°左右运动丧失。肩s骨下裂(57%)与腱切术(47%)之间在6个月内未能达到RTP标准的差异无统计学意义(P = .49)。未能达到强度或ROM标准的独立危险因素为术前美国肩肘外科医师评分(每降低10分:调整后的优势比[aOR],1.61; 95%CI,1.14-2.43; P = 0.006),西安大略省肩部不稳定性指数百分比(每下降10%:aOR,0.61; 95%CI,0.38-0.92; P = .01),并且术前在任何平面上的ROM侧不足≥20°(aOR,5.01 ; 95%CI,1.42-21.5; P = 0.01)或外展不足(在外展90°时出现缺陷)(每增加10°缺陷:aOR,1.64; 95%CI,1.06-2.88; P = .02)。结论Latarjet手术后6个月,大部分运动员未能达到全部力量和ROM。
更新日期:2020-03-16
down
wechat
bug