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Arthroscopic Latarjet With Cortical Buttons Versus Open Latarjet With Screws: A Short-Term Comparative Study
The American Journal of Sports Medicine ( IF 4.2 ) Pub Date : 2022-09-02 , DOI: 10.1177/03635465221120076
Mathieu Girard 1, 2 , Yoann Dalmas 1, 2 , Vincent Martinel 3 , Pierre Mansat 1, 2, 4 , Nicolas Bonnevialle 1, 2, 4, 5
Affiliation  

Background:

The arthroscopic bone block procedure according to Latarjet remains a controversial subject, and few comparative studies have demonstrated the benefit of arthroscopy over open surgery.

Purpose/Hypothesis:

The objective of this study was to compare both procedures by analyzing the short-term clinical results. The hypothesis was that the arthroscopic procedure is superior to the standard open procedure.

Study Design:

Cohort study; Level of evidence, 3.

Method:

This was a retrospective comparative study. Patients treated for chronic anterior instability by arthroscopic Latarjet with double cortical buttons (group A) or open Latarjet with screws (group O) with a minimum follow-up of 12 months were included. Intraoperative (duration, complications) and postoperative (complications, pain, mobility, functional scores, resumption of sport, Patient and Observer Scar Assessment Scale scar aesthetics, satisfaction) data were compared.

Results:

In total, 50 patients were included (n = 24 in group A, n = 26 in group O). Operating time was longer in group A (103 vs 61 min; P = .001). The average number of days on analgesics was higher in group A (8.9 vs 5.3 days; P = .04). The complication rate was similar for the 2 groups (12.5% vs 27%; P = .46). At 3 months, the loss of external rotation was greater in group A (–33° vs −18°; P = .01), and resumption of sports was less frequent (11% vs 48%; P = .01). At 12 months, the average scores were excellent, with no significants differences between the 2 groups: Walch-Duplay average, 90 points; Rowe, 94 points; Subjective Shoulder Value (SSV), 92.5%; sport SSV, 85%; and Patient and Observer Scar Assessment Scale score, 17.2 points.

Conclusion:

Over the short term, this comparative study did not prove the superiority of the cortical-button arthroscopic Latarjet procedure over the open Latarjet procedure. A delay in the resumption of sports, longer time to recover range of motion, and no benefit regarding postoperative pain or the aesthetic aspect of the scar were observed in this study with the arthroscopic procedure.



中文翻译:

带皮质按钮的关节镜 Latarjet 与带螺钉的开放式 Latarjet:短期比较研究

背景:

根据 Latarjet 的关节镜骨块手术仍然是一个有争议的主题,很少有比较研究证明关节镜手术优于开放手术。

目的/假设:

本研究的目的是通过分析短期临床结果来比较这两种方法。假设是关节镜手术优于标准开放手术。

学习规划:

队列研究;证据水平,3。

方法:

这是一项回顾性比较研究。包括通过关节镜 Latarjet 双皮质按钮(A 组)或开放式 Latarjet 螺钉(O 组)治疗慢性前部不稳的患者,至少随访 12 个月。比较术中(持续时间、并发症)和术后(并发症、疼痛、活动能力、功能评分、恢复运动、患者和观察者疤痕评估量表疤痕美学、满意度)数据。

结果:

总共包括 50 名患者(A 组 n = 24,O 组 n = 26)。A 组的手术时间更长(103 对 61 分钟;P = .001)。A 组平均使用镇痛药的天数更高(8.9 天 vs 5.3 天;P = .04)。两组的并发症发生率相似(12.5% vs 27%;P = .46)。在 3 个月时,A 组的外旋损失更大(–33° vs -18°;P = .01),恢复运动的频率较低(11% vs 48%;P= .01)。12 个月时,平均成绩优异,两组间无显着差异:Walch-Duplay 平均,90 分;罗,94 分;主观肩值(SSV),92.5%;运动型 SSV,85%;患者和观察者疤痕评估量表评分,17.2 分。

结论:

在短期内,这项比较研究并未证明皮质按钮关节镜 Latarjet 手术优于开放式 Latarjet 手术。在这项使用关节镜手术的研究中观察到恢复运动的延迟、恢复运动范围的时间更长,并且在术后疼痛或疤痕的美观方面没有任何益处。

更新日期:2022-09-03
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