Clinical and Radiographic Outcomes in Arthroscopic InlayBristow Surgery With Screw Fixation vs Suture-button Fixation

Study Overview
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Brief Summary
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Retrospective comparative case-cohort study to investigate the efficacy of the modified arthroscopic Bristow-Latarjet surgery and to compare the clinical and radiographic outcomes using screw fixation vs suture-button fixation.

Detailed Description
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Background：Some studies have advocated the use of suture-button fixation during Bristow-latarjet surgery to reduce complications associated with screw fixation. However, these studies are not comparative studies, and their data are relatively incomplete. Purpose: To compare the clinical and radiographic outcomes using screw fixation vs suture-button fixation. Study Design: Retrospective comparative case-cohort study Methods: Patients who underwent the modified arthroscopic Bristow-Latarjet surgery between June 2015 and February 2018 were selected. Shoulders were separated into two groups based on surgical fixation method. Radiological results on 3D CT scan and clinical results were assessed preoperatively, immediately after operation, and postoperatively at 3 months, 6 months, 1 year and during the final follow-up.

Official Title
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Clinical and Radiographic Outcomes in Arthroscopic InlayBristow Surgery With Screw Fixation vs Suture-button Fixation

Conditions
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Shoulder; Dislocation, Chronic

Intervention / Treatment
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* Procedure: Bristow surgery fixed by the screw
* Procedure: Bristow surgery fixed by the suture button


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a glenoid defect ≥10% contact sport athletes with a glenoid defect < 10% failure after Bankart repair. Exclusion Criteria: epilepsy multidirectional shoulder instability concomitant other lesions including rotator cuff tear, symptomatic acromioclavicular joint pathology or pathological involvement of the long head of the biceps Follow-up was less than 2 years or incomplete follow-up data.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| screw group<br>coracoid bone block fixed by the screw | Procedure: Bristow surgery fixed by the screw<br>* Bristow surgery fixed by the screw<br>|
| button group<br>coracoid bone block fixed by the suture-button | Procedure: Bristow surgery fixed by the suture button<br>* Bristow surgery fixed by the suture button<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS for pain score | The visual analog scale (VAS) for pain score is the most commonly used to describe pain levels in patients, ranging from 0 to 10, with a higher score indicating more intense pain. | 2 years after surgery | 
| ASES score | The American Shoulder and Elbow Surgeons (ASES) score is the most commonly used score to describe the function of patients' shoulder joints, ranging from 0 to 100. The higher the score, the better the function of patients' shoulder joints. | 2 years after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active shoulder ranges of motion | internal rotation at the side, and external and internal rotation at 90° of abduction, | 2 years after surgery | 
| Bone block position | Bone block position was evaluated using postoperative CT scans.The ideal position of the bone block was defined as flush to the anterior glenoid rim in the axial view and 4 o'clock in the En face view. The bone block was considered too lateral if it went beyond the glenoid rim by more than 5 mm and it was judged to be too medial if it was medial to the rim by more than 5 mm. | immediately after surgery. | 
| Bone union | Graft union with the glenoid was assessed using postoperative CT scans. ''Bony union'' of the transplant was defined as no radiolucent zone; ''fibrous union,'' when the transplant had a radiolucent zone of less than 5 mm; and ''migration,'' when the zone was 5 mm or more. | 3 months after surgery, 6 months after surgery, 1 year after surgery and 2 years after surgery |