Multicenter Clinical Cohort Study of Modified Flexible Fixation Latarjet Procedure for Recurrent Shoulder Dislocation
The shoulder joint is the most flexible joint of human body and shoulder joint dislocation is the most common joint dislocation of human body. Currently, there are different treatments for anterior shoulder dislocation, but for young patients with high sports requirements and apparent glenoid defect, soft tissue repair is not enough otherwise patients will suffer a high recurrent rate.
In 1954, M. Latarjet invented the coracoid process osteotomy and transposition technique, called the Latarjet procedure, which was a bony repair technique and was later promoted by G. Walch. This technique not only reconstructs the defect glenoid, the sling effect attached to the conjoint tendon also strengthens the anterior and inferior structure. Due to the advantages of low recurrence rate after Latarjet procedure, high rate of patients returning to sports and high satisfaction, it has become the only surgery that has been widely used in more than ten similar surgeries in history. In 2007, French physician Lafosse successfully completed the technique under arthroscopy. However, this surgery traditionally uses screws to fix the bone block, but screw fixation has difficulties like exposed nail head, uncertain bone block positioning, and high absorption rate of the bone block. In 2012, P.Boileau further improved this technique, innovating to avoid the above-mentioned complications through suture button fixation. However, since the Latarjet procedure was invented for decades, scholars have been worried about the unavoidable defects of this technique including the destruction of the coracoacomial arch, pectoralis minor injury and a series of complications caused by non-anatomical reconstruction of the glenoid.
In order to further develop this technology, make it more simple, easy to promote, and safer, based on our clinical and basic research on flexible fixation Latarjet technique for more than 8 years, we have innovatively developed an individualized and improved flexible fixation Latarjet technique that preserves the coracoacomial arch. We assumed that our modified technique, which retains the coracoacomial arch, 1) has the same satisfactory clinical effect. 2) The individualized reconstruction of glenoid defect is more identical with the biomechanics of the shoulder joint. The bone block will finally be remodeled according to the best fit circle. 3) The tiny subscapular tendon split is less damaged and safer.
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Typ studiów
Zapisy (Oczekiwany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Liu Haifeng, MD
- Numer telefonu: +8613713899307
- E-mail: 819811255@qq.com
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
- Age 18-59 years, gender unlimited.
- Patients with recurrent shoulder dislocation who were judged by clinicians to be suitable for modified flexible fixation Latarjet procedure according to surgical indications (1. Glenoid bone defect>20% 2. Glenoid defect>15% and ISIS>6 3. Glenoid defect>10% and competitive athletes)
- Volunteers to join the study and sign informed consent
Exclusion Criteria:
- Clinical and imaging diagnosis combined with other shoulder diseases, such as frozen shoulder, rotator cuff injury, shoulder joint degeneration.
- Basic diseases of important organs ( including severe osteoporosis, dysfunction of important organs, connective tissue diseases, neuropsychiatric disorders, epilepsy, etc. )
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Eksperymentalny: Individualized Lutajet operative group
Arthroscopic modified individualized flexible Latarjet procedure with preservation of the coracoacromial arch.
During the procedure, we perform coracoid osteotomy with preservation of coracoacromial arch, then split subscapular tendon, transfer the bone graft and fix it with double button under arthroscopy.
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The modifications were as follows: (1)the coracoid graft and conjoint tendon were prepared using a mini-open technique with an incision of 2.5 cm and coracoacromial ligament were preserved.
A total of 2 bone tunnels were drilled.
(2)The anterior (including part of the incision used for obtaining the graft), standard antelateral, and posterior portals were set.
(3) The glenoid was marked at the 4-o'clock position, and then the subscapularis muscle was split.
(4)The glenoid tunnel was drilled where the suture linked to the graft was passed, and the graft was pulled to the glenohumeral joint via the sutures.
A knotless suture anchor for antirotation (PushLock; Arthrex) was fixed to the glenoid to prevent rotation of the graft.
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change in the Rowe Score
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Dr. Carter R. Rowe, an orthopedic shoulder specialist at the Massachusetts General Hospital in Boston, USA, proposed in the JBJS magazine in the United States in 1978 that the Rowe score scale for the evaluation of the clinical effects of repair surgery for shoulder joint instability.
Including stability, mobility and functional evaluation, the higher the score, the higher the stability and the better the shoulder function.
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change in the ASES score
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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The ASES (American Association of Shoulder and Elbow Surgery scores) are the shoulder joint function evaluation standards adopted by the American Association of Shoulder and Elbow Surgeons in 1993.
The system is a percentile system that needs to be converted.
The pain in the assessment part of the patient and the cumulative daily activities each account for 50%.
The full score is 100 points.
The higher the score, the better the shoulder joint function.
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Change in the Constant-Murley score
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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The Constant-Murley Shoulder Scoring Scale was designed by Christopher Constant and Alan Murley in 1986.
It is mainly used to assess the severity of shoulder-related diseases.
The scale has good reliability and validity, including pain and function.
, Mobility and muscle strength, the total score is 100, the higher the score, the better the function.
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Change in the Visual Analogue Scale
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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The visual analogue scale (VAS) is used for pain assessment.
It is widely used in clinical practice in China.
The basic method is to use a moving ruler about 10cm long, with 10 scales on one side, and the two ends are respectively "0" and "10" points.
A point of 0 means no pain.
A score of 10 represents the most severe pain that is unbearable.
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Change in the Range of Motion
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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The degree of movement of the shoulder joint can reflect the recovery of shoulder joint function, including flexion, extension, abduction, adduction, external rotation and internal rotation.
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Change in the bone healing
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Through CT scan and 3D reconstruction, we detect the change of bone healing and reshaping during different time period.
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Change in the Samilson-Prieto score
Ramy czasowe: Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Through X ray of true AP view to evaluate the degeneration of the shoulder joint
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Preoperative, Day 1, Month 6, Month 12, Month 18, Month 24
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Współpracownicy i badacze
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Oczekiwany)
Zakończenie podstawowe (Oczekiwany)
Ukończenie studiów (Oczekiwany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- LUWEI
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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