Background:

Rapid consolidation of the bone block is paramount for the success of the Latarjet procedure. Noncannulated screws have shown satisfactory long-term bone block fusion, while cannulated screws are challenged with inferior mechanical properties and fusion rates.

Purpose:

To report outcomes of the Latarjet procedure using cannulated screws, notably bone block fusion and complication rates at 3 months, as well as clinical scores and return to sports at minimum 2 years postoperatively.

Study Design:

Case series; Level of evidence, 4.

Methods:

We reviewed the records of 124 consecutive patients (124 shoulders) who underwent primary Latarjet procedures using cannulated screws between 2015 and 2018. All patients underwent clinical examination at 3 months postoperatively, including range of motion and radiographs to assess graft fusion. The Walch-Duplay score, Rowe score, Subjective Shoulder Value, and visual analog scale for pain were collected at a minimum follow-up of 2 years.

Results:

Overall, 9 patients (7%) required reoperation: 7 (6%) had screw removal for unexplained residual pain, 1 (0.8%) had lavage for deep infection, and 1 (0.8%) had evacuation to treat a hematoma. Furthermore, 3 patients (2.4%) had recurrent instability, none of whom underwent reoperation. At 3-month follow-up, all 124 shoulders showed complete radiographic graft fusion, and at 40 ± 11 months (mean ± SD; range, 24-64 months), 88% of patients had returned to sport (109/124), the Walch-Duplay score was 86 ± 14, Rowe was 84 ± 15, Subjective Shoulder Value was 88 ± 11, and visual analog scale for pain was 1 ± 1.

Conclusion:

The clinical relevance of these findings is that 4.5-mm cannulated screws are safe and effective for primary Latarjet procedures and grant adequate graft healing, with low recurrence of instability and a high rate of return to sports.

中文翻译：

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在主要 Latarjet 手术中使用空心螺钉

背景：

骨块的快速巩固对于 Latarjet 手术的成功至关重要。非空心螺钉已显示出令人满意的长期骨块融合，而空心螺钉则面临着较差的机械性能和融合率的挑战。

目的：

报告使用空心螺钉进行 Latarjet 手术的结果，特别是 3 个月时的骨块融合和并发症发生率，以及术后至少 2 年的临床评分和恢复运动。

学习规划：

案例系列；证据水平，4。

方法：

我们回顾了 2015 年至 2018 年间连续 124 名患者（124 肩）的记录，这些患者使用空心螺钉进行了主要的 Latarjet 手术。所有患者在术后 3 个月接受了临床检查，包括运动范围和 X 光片以评估移植物融合。在至少 2 年的随访中收集了 Walch-Duplay 评分、Rowe 评分、主观肩关节值和疼痛视觉模拟量表。

结果：

总体而言，9 名患者 (7%) 需要再次手术：7 名 (6%) 因无法解释的残余疼痛而拔除螺钉，1 名 (0.8%) 因深部感染而进行灌洗，1 名 (0.8%) 因血肿而进行疏散。此外，3 名患者（2.4%）出现反复不稳，均未接受再次手术。在 3 个月的随访中，所有 124 个肩部均显示完全的 X 线移植物融合，并且在 40 ± 11 个月（平均值 ± SD；范围，24-64 个月）时，88% 的患者恢复了运动（109/124）， Walch-Duplay 评分为 86 ± 14，Rowe 为 84 ± 15，主观肩关节值为 88 ± 11，疼痛视觉模拟量表为 1 ± 1。

结论：

这些发现的临床意义在于，4.5 毫米空心螺钉对于 Latarjet 初次手术是安全有效的，并且可以实现充分的移植物愈合，不稳定复发率低，运动恢复率高。