BACKGROUND The preoperative number of dislocations has been previously proved to be a major factor influencing the results after Bankart repair with more preoperative dislocations correlated with higher recurrence rates and more reoperations. This could possibly be because of the lower quality of the tissue repaired during the procedure after multiple dislocations. On the other hand, the Latarjet procedure does not "repair" but rather reconstructs and augments the anterior glenoid. PURPOSE/HYPOTHESIS The main objective was to report the clinical outcomes of patients undergoing a Latarjet procedure after 1 dislocation versus multiple (≥2) dislocations. The hypothesis was that the preoperative number of dislocations would not influence clinical results. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Patients older than 18 years who had undergone a primary Latarjet procedure for shoulder instability with at least 2 years of follow-up were included. Three different techniques were used: a mini-open technique using 2 screws, an arthroscopic technique using 2 screws, and an arthroscopic technique using 2 cortical buttons. Patients were evaluated and answered a questionnaire to assess the number of episodes of dislocation before surgery, the time between the first dislocation and surgery, recurrence of the dislocation, revision surgery, the Walch-Duplay score, the Simple Shoulder Test score, and the visual analog scale (VAS) score for pain. RESULTS A total of 308 patients were included for analysis with a mean follow-up of 3.4 ± 0.8 years. Of that, 83 patients were included in the first-time dislocation group and 225 in the recurrent dislocation group. At last follow-up, the rates of recurrence and reoperation were not significantly different between groups: 4.8% in the first-time dislocation group versus 3.65% in the recurrent dislocation group and 6.1% versus 4.0%, respectively. The overall Walch-Duplay scores at last follow-up were also comparable between the 2 groups, 67.3 ± 24.85 and 71.8 ± 25.1, even though the first-time dislocation group showed a lower pain subscore (15.0 ± 8.6 vs 18.0 ± 7.5; P = .003). The VAS for pain was also significantly higher in the first-time dislocation group compared with the recurrent dislocation group (1.8 ± 2.3 vs 1.2 ± 1.7; P = .03). CONCLUSION The number of episodes of dislocation before surgery does not affect postoperative instability rates and reoperation rates after the Latarjet procedure. However, patients with first-time dislocations had more postoperative pain compared with patients with recurrent dislocations before surgery.

中文翻译：

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Latarjet手术后的结果：首次与复发性脱位患者。

背景技术以前已经证明，术前脱位的数量是影响Bankart修复后结果的主要因素，术前脱位的更多与更高的复发率和更多的再手术相关。这可能是由于在多次脱位后的手术过程中修复的组织质量较低。另一方面，Latarjet手术不会“修复”而是重建并增强前盂盂。目的/假设主要目的是报告在1例脱位与多发（≥2例）脱位后接受Latarjet手术的患者的临床结局。假设是术前脱位的数目不会影响临床结果。研究设计队列研究；证据水平3。方法包括18岁以上因肩关节不稳而接受了至少2年随访的初次Latarjet手术的患者。使用了三种不同的技术：使用2个螺钉的微型打开技术，使用2个螺钉的关节镜技术和使用2个皮质按钮的关节镜技术。对患者进行了评估并回答了问卷，以评估术前脱位的发作次数，首次脱位和手术之间的时间，脱位的复发，翻修手术，Walch-Duplay得分，简单肩部测试得分和视觉疼痛的模拟量表（VAS）评分。结果共纳入308例患者，平均随访时间为3.4±0.8年。其中，首次脱位组包括83例患者，复发性脱位组包括225例。在最后一次随访中，各组的复发率和再手术率无显着差异：首次脱位组为4.8％，复发性脱位组分别为3.65％和6.1％对4.0％。即使首次脱位组的疼痛评分较低（25.0±18.0±7.5 vs 18.0±7.5），两组最后一次随访时的Walch-Duplay总体评分也相当，分别为67.3±24.85和71.8±25.1。 = .003）。与复发性脱位组相比，首次脱位组的疼痛VAS也显着更高（1.8±2.3 vs 1.2±1.7； P = .03）。结论术前脱位的发作次数不影响Latarjet手术后的术后不稳定率和再次手术率。但是，与手术前复发性脱位的患者相比，初次脱位的患者术后疼痛更大。