Arthroscopic Latarjet Procedure With Anterior Capsular Reconstruction: Clinical Outcome and Radiologic Evaluation With a Minimum 2-Year Follow-Up

作者：Zhu, Yi-Ming; Jiang, Chunyan^*; Song, Guanyang; Lu, Yi; Li, Fenglong

来源：Arthroscopy-The Journal of Arthroscopic and Related Surgery, 2017, 33(12): 2128-2135.

DOI：10.1016/j.arthro.2017.06.014

• COMPUTED-TOMOGRAPHY SCAN
• SHOULDER INSTABILITY
• BONE-BLOCK
• GRAFT OSTEOLYSIS

Purpose: To investigate the clinical and radiographic outcomes of the modified arthroscopic Latarjet procedure at a minimum of 2 years after surgery. Methods: Patients who had traumatic unidirectional anterior shoulder instability and treated with a modified arthroscopic Latarjet procedure were included. During surgery, the anterior capsule was preserved and repaired back to the glenoid after the coracoid transfer. The clinical results (range of motion, American Shoulder and Elbow Surgeons [ASES] score, Constant-Murley score, and Rowe score) and computed tomographic results were followed. Results: From February 2013 to September 2014, 52 consecutive patients were included. The average duration of follow-up was 28.4 months (range, 24.0-41.7 months). At final follow-up, no recurrent dislocation had occurred. The ASES score and Rowe score improved significantly (ASES score from 85.6 +/- 12.7 before surgery to 93.6 +/- 5.4 after surgery, P < .0001; Rowe score from 41.5 +/- 7.2 before surgery to 92.2 +/- 8.7 after surgery, P < .0001). No significant change was found regarding range of motion and the Constant-Murley score. Bone union was achieved in all cases. The transferred coracoid was at the level of the glenoid in all cases. The transferred coracoid was placed below the equator in 48 of 52 cases (92.3%). The orientation of the screw was 22.6 degrees +/- 10.8 degrees. Bone resorption around the proximal screw was significantly more prominent than that around the distal screw (P < .0001). Conclusions: The arthroscopic Latarjet procedure with concomitant anterior capsular reconstruction can achieve satisfactory clinical outcomes for the treatment of anterior shoulder instability with marked glenoid bone loss at a minimum of 2 years' follow-up. A satisfactory coracoid graft position, proper screw orientation, and high healing rate of the transferred coracoid can be expected. Bone resorption around the proximal screw is more severe than that around the distal screw.

• 出版日期2017-12
• 单位北京积水潭医院; 北京大学