Randomized clinical trial, parallel 1:1, comparing Latarjet to Modified Eden-Hybinette (iliac bone crest + capsular repair) for recurrent traumatic anterior glenohumeral dislocation.
The Latarjet technique has proven reliable for the treatment of dislocations, with lower recurrence rates (5%) even in the presence of bone lesions. This technique allows a stable fixation of the graft, with 2 screws, and the dynamic effect of the conjoint tendon, the sling effect. However, several complications are described, such as neurological injuries, nonunion and graft resorption. Hamel et al, showed that vascularization of the coracoid graft is impaired during the course of Latarjet procedure. Together with the small thickness of the coracoid, it may justify its high rate of resorption. The Eden-Hybinette surgery does not have the potential advantages of the sling effect. However, it allows a better restoration of the area of the glenoid, without the risks related to the coracoid osteotomy. All clinical studies about the different bone grafting techniques have a low quality. Furthermore, there is no comparative study of the techniques of Latarjet and Eden-Hybinette.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Open anterior glenoid bone graft from coracoid process
Open anterior glenoid bone graft from iliac bone crest, with capsular suture and screw fixation
Instituto de Ortopedia e Traumatologia
São Paulo, São Paulo, Brazil
RECRUITINGWestern Ontario Shoulder Instability Index (WOSI)
Instability score
Time frame: 2 years
ROWE score
Time frame: 2 years
Visual analog scale (VAS) for shoulder pain
Time frame: 2 years
VAS for iliac pain
Time frame: 6 weeks
VAS for iliac pain
Time frame: 3 months
VAS for iliac pain
Time frame: 2 years
Single Assessment Numeric Evaluation (SANE)
Time frame: 2 years
Dislocation recurrence rate
Time frame: 2 years
Rate of complications and reoperations
Time frame: 2 years
Kible scale for Scapular movement
Scale for scapular positioning. Clinical measurement
Time frame: 2 years
Categoric evaluation for scapular movement
Video evaluation for normal or dyskinesis of the scapula movement
Time frame: 2 years
Tomographic evaluation
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Graft union, graft position and resorption
Time frame: 2 years
Radiographic evaluation
Graft union, graft position and resorption
Time frame: 2 years
Degree of Shoulder Involvement in Sports (DOSIS ) scale
return to sport scale
Time frame: 2 years