Mid-term effectiveness of modified arthroscopic suture button fixation Latarjet procedure for treatment of recurrent anterior shoulder dislocations_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Xiuqi , ZHONG Hehe , CHEN Fang , JIN Ying , XIANG Kuan , XIE Tao , XIONG Huazhang ,  WU Shuhong

Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563000, P. R. China;

Corresponding author：

WU Shuhong, Email: 15329112966@163.com

Keywords：

Modified suture button fixation Latarjet procedure; arthroscopy; recurrent anterior shoulder dislocation; mid-term effectiveness

DOI：

10.7507/1002-1892.202403125

Video：

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Objective To summarize mid-term effectiveness of modified arthroscopic suture button fixation Latarjet procedure for treatment of recurrent anterior shoulder dislocations. Methods Between January 2018 and October 2020, 30 patients with recurrent anterior shoulder dislocations were treated with modified arthroscopic suture button fixation Latarjet procedure. There were 19 males and 11 females with an average age of 27.3 years (range, 18-41 years). The shoulder dislocation occurred 3-7 times, with an average of 4.9 times. The time from the last dislocation to operation was 3-10 days, with an average of 4.1 days. Glenoid defects exceeded 20% in all cases. There were 27 cases of Hill-Sachs lesions. The joint pain and function were estimated by visual analogue scale (VAS) score, University of California, Los Angeles (UCLA) score, Rowe score, American Association for Shoulder and Elbow Surgery (ASES) score, Walch-Duplay score, and the range of external rotation at 0° and external rotation at 90° abduction of shoulder before operation and at 1 month, 6 months, and last follow-up. The X-ray film, CT scan and three-dimensional reconstruction were reviewed to observe the position, healing, and absorption of the coracoid graft, correction of glenoid defect, and joint degeneration.Results The operation time ranged from 51 to 79 minutes, with an average of 68.4 minutes. All incisions healed without complications such as nerve or blood vessel injury. All patients were followed up 36-60 months with an average of 44.6 months. The VAS score, UCLA score, Rowe score, ASES score, Walch-Duplay score, and the range of external rotation at 0° and external rotation at 90° abduction after operation significantly improved when compared with preoperative values (P<0.05). All indicators further improved with time, and the differences between different time points after operation were significant (P<0.05). Imaging review showed that the coracoid graft was located in the anteroinferior glenoid at 1 day after operation, and no occurrence of shoulder osteoarthritis was found during follow-up. The anatomical structure of the glenoid was normal, and no delayed healing or non-union of the coracoid graft occurred. At 20 months after operation, arthroscopic re-exploration was performed in 1 case due to fracutre caused by falling injury revealed the good shaping of the coracoid graft, smooth glenoid, and no bone resorption or osteoarthritis. Conclusion For recurrent anterior shoulder dislocations, the modified arthroscopic suture button fixation Latarjet procedure can obtain good recovery of shoulder function and low incidence of complications and has a good mid-term effectiveness.

Citation： LIU Xiuqi, ZHONG Hehe, CHEN Fang, JIN Ying, XIANG Kuan, XIE Tao, XIONG Huazhang, WU Shuhong. Mid-term effectiveness of modified arthroscopic suture button fixation Latarjet procedure for treatment of recurrent anterior shoulder dislocations. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(6): 679-683. doi: 10.7507/1002-1892.202403125 Copy

1.	Provencher MT, Midtgaard KS, Owens BD, et al. Diagnosis and management of traumatic anterior shoulder instability. J Am Acad Orthop Surg, 2021, 29(2): e51-e61.
2.	张春森, 庞龙, 熊燕, 等. 关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效. 中国修复重建外科杂志, 2023, 37(5): 545-550.
3.	Guan H, Zhang B, Ye Z, et al. Glenoid bony morphology along long diameter is associated with the occurrence of recurrent anterior shoulder dislocation: a case-control study based on three-dimensional CT measurements. Int Orthop, 2022, 46(8): 1811-1819.
4.	Belk JW, Wharton BR, Houck DA, et al. Shoulder stabilization versus immobilization for first-time anterior shoulder dislocation: a systematic review and meta-analysis of level 1 randomized controlled trials. Am J Sports Med, 2023, 51(6): 1634-1643.
5.	邵振兴, 张淑涵, 蒋艳芳, 等. 关节镜下结合改良线袢固定的“双嵌入式”髂骨移植翻修术治疗肩关节复发性前脱位: 初期两年随访结果. 中国运动医学杂志, 2021, 40(7): 509-517.
6.	Shaha J. Editorial commentary: Recurrent anterior shoulder instability with glenoid bone loss requires restoring the bone. Arthroscopy, 2022, 38(3): 682-683.
7.	Arner JW, Ruzbarsky JJ, Bradley JP, et al. Management of complex and revision anterior shoulder instability. Arthroscopy, 2022, 38(5): 1396-1397.
8.	Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg, 2016, 25(1): 78-89.
9.	Rutgers C, Verweij LPE, Priester-Vink S, et al. Recurrence in traumatic anterior shoulder dislocations increases the prevalence of Hill-Sachs and Bankart lesions: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2022, 30(6): 2130-2140.
10.	徐征, 代飞, 杨金松, 等. 肩关节复发性脱位盂肱关节一致性与稳定性相关性研究. 中国修复重建外科杂志, 2023, 37(9): 1094-1097.
11.	Ladd LM, Crews M, Maertz NA. Glenohumeral joint instability: a review of anatomy, clinical presentation, and imaging. Clin Sports Med, 2021, 40(4): 585-599.
12.	Hurley ET, Matache BA, Wong I, et al. Anterior shoulder instability part i-diagnosis, nonoperative management, and Bankart repair-An international consensus statement. Arthroscopy, 2022, 38(2): 214-223. e7.
13.	王东昕, 李盛海, 李靖年, 等. 关节镜下髂骨游离悬吊植骨治疗肩关节复发性脱位. 中国矫形外科杂志, 2021, 29(8): 735-737,741.
14.	Kelley TD, Clegg S, Rodenhouse P, et al. Functional rehabilitation and return to play after arthroscopic surgical stabilization for anterior shoulder instability. Sports Health, 2022, 14(5): 733-739.
15.	Verweij LPE, Sierevelt IN, van der Woude HJ, et al. Surgical intervention following a first traumatic anterior shoulder dislocation is worthy of consideration. Arthroscopy, 2023, 39(12): 2577-2586.

1. Provencher MT, Midtgaard KS, Owens BD, et al. Diagnosis and management of traumatic anterior shoulder instability. J Am Acad Orthop Surg, 2021, 29(2): e51-e61.
2. 张春森, 庞龙, 熊燕, 等. 关节镜下Bankart修复术治疗复发性肩关节前脱位的中期疗效. 中国修复重建外科杂志, 2023, 37(5): 545-550.
3. Guan H, Zhang B, Ye Z, et al. Glenoid bony morphology along long diameter is associated with the occurrence of recurrent anterior shoulder dislocation: a case-control study based on three-dimensional CT measurements. Int Orthop, 2022, 46(8): 1811-1819.
4. Belk JW, Wharton BR, Houck DA, et al. Shoulder stabilization versus immobilization for first-time anterior shoulder dislocation: a systematic review and meta-analysis of level 1 randomized controlled trials. Am J Sports Med, 2023, 51(6): 1634-1643.
5. 邵振兴, 张淑涵, 蒋艳芳, 等. 关节镜下结合改良线袢固定的“双嵌入式”髂骨移植翻修术治疗肩关节复发性前脱位: 初期两年随访结果. 中国运动医学杂志, 2021, 40(7): 509-517.
6. Shaha J. Editorial commentary: Recurrent anterior shoulder instability with glenoid bone loss requires restoring the bone. Arthroscopy, 2022, 38(3): 682-683.
7. Arner JW, Ruzbarsky JJ, Bradley JP, et al. Management of complex and revision anterior shoulder instability. Arthroscopy, 2022, 38(5): 1396-1397.
8. Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg, 2016, 25(1): 78-89.
9. Rutgers C, Verweij LPE, Priester-Vink S, et al. Recurrence in traumatic anterior shoulder dislocations increases the prevalence of Hill-Sachs and Bankart lesions: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2022, 30(6): 2130-2140.
10. 徐征, 代飞, 杨金松, 等. 肩关节复发性脱位盂肱关节一致性与稳定性相关性研究. 中国修复重建外科杂志, 2023, 37(9): 1094-1097.
11. Ladd LM, Crews M, Maertz NA. Glenohumeral joint instability: a review of anatomy, clinical presentation, and imaging. Clin Sports Med, 2021, 40(4): 585-599.
12. Hurley ET, Matache BA, Wong I, et al. Anterior shoulder instability part i-diagnosis, nonoperative management, and Bankart repair-An international consensus statement. Arthroscopy, 2022, 38(2): 214-223. e7.
13. 王东昕, 李盛海, 李靖年, 等. 关节镜下髂骨游离悬吊植骨治疗肩关节复发性脱位. 中国矫形外科杂志, 2021, 29(8): 735-737,741.
14. Kelley TD, Clegg S, Rodenhouse P, et al. Functional rehabilitation and return to play after arthroscopic surgical stabilization for anterior shoulder instability. Sports Health, 2022, 14(5): 733-739.
15. Verweij LPE, Sierevelt IN, van der Woude HJ, et al. Surgical intervention following a first traumatic anterior shoulder dislocation is worthy of consideration. Arthroscopy, 2023, 39(12): 2577-2586.

Chinese Journal of Reparative and Reconstructive Surgery

Mid-term effectiveness of modified arthroscopic suture button fixation Latarjet procedure for treatment of recurrent anterior shoulder dislocations

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