Background:

Recurrent anterior glenohumeral instability caused by a humeral avulsion of the glenohumeral ligament (HAGL) lesion has been studied, but very limited long-term evidence is available.

Purpose:

To retrospectively review patients with a HAGL lesion who underwent an open Latarjet procedure for recurrent anterior shoulder instability.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 16 patients with complete clinical and radiological data were available for a review. Clinical outcomes were assessed by range of motion, apprehension testing, the visual analog scale for pain, the Walch-Duplay score, the Rowe score, the Constant-Murley score, the Subjective Shoulder Value, and return to sports. Radiographs were reviewed for osteoarthritis and complications.

Results:

The median age of patients at the time of surgery was 28 years (range, 18-42 years). All patients were male with no hyperlaxity. The median follow-up time was 10 years (range, 2.8-15 years). Postoperative range of motion showed recovered forward elevation (median, 175°), external rotation (median, 62°), and internal rotation (median, 9 points). Overall, 87% returned to sports, with 68% to the same level and 93% satisfied or very satisfied. Median clinical outcomes were the following: visual analog scale score, 1 (range, 0-2); Walch-Duplay score, 86 (range, 75-100); Rowe score, 95 (range, 90-100); Constant-Murley score, 77 (range, 74-79); and Subjective Shoulder Value, 88% (range, 80%-95%). There were no recurrent dislocations or subluxations. One patient described mild long-term pain, and 1 patient had persistent stiffness. Other complications included 12% with subjective apprehension, 1 patient with a wound infection, and another patient with delayed bone graft union. Additionally, 56% of cases had mild postoperative arthritis at the final follow-up. There were no reoperations.

Conclusion:

The open Latarjet procedure provided good outcomes with acceptable complication rates in the long term for patients with HAGL lesions. It is an effective treatment option and a safe alternative to arthroscopic or open HAGL repair.

中文翻译：

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开放式 Latarjet 手术治疗盂肱韧带损伤的肱骨撕脱后的长期结果

背景：

已经研究了由盂肱韧带撕裂（HAGL）损伤引起的复发性盂肱前部不稳定，但可获得的长期证据非常有限。

目的：

回顾性回顾因复发性前肩不稳而接受开放式 Latarjet 手术的 HAGL 病变患者。

学习规划：

案例系列；证据水平，4。

方法：

共有 16 名具有完整临床和放射学数据的患者可供审查。临床结果通过运动范围、恐惧测试、疼痛视觉模拟量表、Walch-Duplay 评分、Rowe 评分、Constant-Murley 评分、主观肩部值和恢复运动进行评估。对骨关节炎和并发症的X光片进行了审查。

结果：

手术时患者的中位年龄为 28 岁（范围为 18-42 岁）。所有患者均为男性，无过度松弛。中位随访时间为 10 年（范围 2.8-15 年）。术后运动范围显示恢复前抬高（中位，175°）、外旋（中位，62°）和内旋（中位，9分）。总体而言，87% 的人重返体育运动，其中 68% 达到相同水平，93% 的人满意或非常满意。中位临床结果如下：视觉模拟量表评分，1（范围，0-2）；Walch-Duplay 得分，86（范围，75-100）；Rowe 评分，95（范围，90-100）；Constant-Murley 得分，77（范围，74-79）；和主观肩值，88%（范围，80%-95%）。没有复发性脱位或半脱位。一名患者描述了轻微的长期疼痛，一名患者持续僵硬。其他并发症包括 12% 的患者有主观忧虑，1 名患者出现伤口感染，另一名患者出现骨移植物愈合延迟。此外，56% 的病例在最终随访时有轻度术后关节炎。没有再手术。

结论：

从长远来看，开放式 Latarjet 手术为 HAGL 病变患者提供了良好的结果和可接受的并发症发生率。它是一种有效的治疗选择，也是关节镜或开放式 HAGL 修复的安全替代方案。