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Vuletić F, Bøe B. Current Trends and Outcomes for Open vs. Arthroscopic Latarjet. Curr Rev Musculoskelet Med 2024; 17:136-143. [PMID: 38467987 PMCID: PMC11068718 DOI: 10.1007/s12178-024-09889-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE OF REVIEW This paper aims to analyze and compare the existing research on open and arthroscopic Latarjet procedures for treating anterior shoulder instability. The review will assess different factors such as graft positioning, functional outcomes, complications, and return-to-play rates for both approaches. The study's primary goal is to establish which technique yields superior outcomes. RECENT FINDINGS Recent studies have suggested that arthroscopic Latarjet surgery can produce outcomes similar to open surgery regarding functional scores and patient satisfaction. Some research indicates that arthroscopy may even provide slightly better results. Both techniques have similar complication rates, but arthroscopy requires a longer learning curve and operating time. It is crucial to ensure the proper placement of the graft, and some studies suggest that arthroscopy may be better at achieving accurate positioning. Both open and arthroscopic Latarjet procedures are equally effective in treating shoulder instability. While arthroscopy offers a faster recovery time and causes less soft tissue damage, it requires surgeons to undergo a steeper learning curve. The optimal graft position for both techniques is still debated. More long-term data is needed to establish superiority. Future research should compare approaches in larger cohorts and identify outcome-affecting factors to improve the treatment of shoulder instability. Both techniques are promising, but arthroscopy may be a better option as the procedure evolves into a less invasive reconstruction.
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Affiliation(s)
- Filip Vuletić
- Department for Orthopaedic and Trauma Surgery, University Hospital "Sveti Duh", Sveti Duh 64, 10000, Zagreb, Croatia
- Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000, Zagreb, Croatia
| | - Berte Bøe
- Division of Orthopaedic Surgery, Oslo University Hospital, Trondheimsveien 235, 0586, Aker, Oslo, Norway.
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Ivković A, Glavčić M, Vuletić F, Janković S. Core Decompression Combined with Intraosseous Autologous Conditioned Plasma Injections Decreases Pain and Improves Function in Patients with Symptomatic Knee Bone Marrow Lesions. Biomedicines 2023; 11:1799. [PMID: 37509439 PMCID: PMC10376709 DOI: 10.3390/biomedicines11071799] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
The purpose of this prospective case series was to determine the effectiveness of using a combination of the core decompression and injection of autologous conditioned plasma (ACP) for the treatment of symptomatic knee bone marrow lesions (BML), as well as to report on the preliminary clinical results based on magnetic resonance imaging (MRI) and patient-reported outcomes (PROMs). Patients with OA-related BML who failed to improve on conservative treatment for three months underwent an identical procedure consisting of arthroscopy, core decompression, and the intraosseous injection of ACP and were followed up for 12 months. A statistically significant reduction in pain and an improvement in function, as measured by the Numeric Pain Rating Scale (NPRS) and Knee Injury and Osteoarthritis Outcome Score (KOOS), was observed at one-week follow-up (8.3 ± 0.8 to 1.5 ± 1.0; p ≤ 0.001 and 33.4 ± 10.6 to 53.9 ± 13.6; p ≤ 0.001 respectively). After six weeks, weight-bearing was allowed, but the trend did not change-the NPRS continued to be low (average 1.4 on 12-month follow-up) and the total KOOS increased 44.6 points from the baseline (average 78.0 on 12-month follow-up). The Whole-Organ Magnetic Resonance Imaging Score improved from 66.1 ± 19.4 prior to surgery to 58.0 ± 15.9 (p < 0.001) after 3 months. In our study, there was no control group, randomisation was not performed, and the sample size was relatively small. A combination of core decompression and the intraosseous injection of ACP into the affected subchondral area proved to be a safe and effective procedure that provides rapid pain relief and a significant increase in joint function up to one year postoperatively.
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Affiliation(s)
- Alan Ivković
- Department of Orthopaedics and Trauma Surgery, University Hospital "Sveti Duh", 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Clinical Medicine, University of Applied Health Sciences, 10000 Zagreb, Croatia
| | - Marin Glavčić
- Department of Orthopaedic and Trauma Surgery, University Hospital "Dubrava", 10000 Zagreb, Croatia
| | - Filip Vuletić
- Department of Orthopaedics and Trauma Surgery, University Hospital "Sveti Duh", 10000 Zagreb, Croatia
| | - Saša Janković
- Department of Orthopaedics and Trauma Surgery, University Hospital "Sveti Duh", 10000 Zagreb, Croatia
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
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Vrgoč G, Vuletić F, Matolić G, Ivković A, Hudetz D, Bulat S, Bukvić F, Janković S. Clinical Outcome of Arthroscopic Repair for Isolated Meniscus Tear in Athletes. Int J Environ Res Public Health 2023; 20:5088. [PMID: 36981997 PMCID: PMC10049165 DOI: 10.3390/ijerph20065088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Increased knowledge of the long-term destructive consequences of meniscectomy has created a shift towards operative repair of isolated meniscus lesions. However, in the literature the results of isolated meniscal repair in athletes currently remain underreported. Our objective was to investigate the clinical and functional outcomes as well as survival and return to sport in patients who underwent meniscal repair after isolated meniscal tear, with a focus on athletes (both professional and recreational) in the study population. This retrospective study included 52 athletes who underwent knee surgery for isolated meniscal tear between 2014 and 2020. Patients with concomitant ligamentous and/or chondral injury were not included in this study. The mean age of the patients was 25.5 years (ranging from 12 to 57 years). The mean follow-up period of all patients was 33.3 months (ranging 10 to 80 months). The mean purpose of the study was to report the return to sport. The International Knee Documentation Committee rating (IKDC), Lysholm score, the Knee Osteoarthritis Outcome Score (KOOS) and Tegner activity level were determined at the follow-up. Failure was defined as re-operation with meniscectomy or revision meniscal repair. In total, 44 out of 52 patients (85%) returned to their previous sports activities. At follow-up, the mean Lysholm score was 90, representing a good to excellent result. Assessment of KOOS (mean value 88.8) and IKDC (mean value 89) scores also showed good to excellent results. A mean level of Tegner scale was 6.2, indicating a relatively high level of sports participation. Failure was encountered in 8 out of 52 knees (15%). Therefore, isolated meniscal repair resulted in good to excellent knee function and most athletes can return to their previous level of sports participation.
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Affiliation(s)
- Goran Vrgoč
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
- Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000 Zagreb, Croatia
| | - Filip Vuletić
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
- Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000 Zagreb, Croatia
| | - Grgur Matolić
- School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
| | - Alan Ivković
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
- School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
- Department of Clinical Medicine, University Applied Health Sciences, Mlinarska cesta 38, 10000 Zagreb, Croatia
| | - Damir Hudetz
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
| | - Stjepan Bulat
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
| | - Frane Bukvić
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
| | - Saša Janković
- Department for Orthopaedic Surgery, University Hospital, “Sveti Duh”, Sveti Duh 64, 10000 Zagreb, Croatia; (F.V.)
- Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, 10000 Zagreb, Croatia
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Živčić Tomić D, Tomić M, Vuletić F, Vrgoč G. Running addiction. J Sports Med Phys Fitness 2023; 63:503-508. [PMID: 36449271 DOI: 10.23736/s0022-4707.22.14285-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Running is a common physical activity of an aerobic nature that is carried out mostly outdoors and presents a healthy lifestyle. However, the positive effect of running often masks the downsides of potential addiction that can compromise an individual's physical, mental, and social functioning. Most often there is a thin and unclear line separating passionate athletes and running addicts. Thus, it is necessary to educate the running community to raise awareness of the negative effects of over-training, prevent complications and injuries and to seek the necessary help. METHODS The study sample consisted of runners from the Croatian population of both genders, aged 18 to 75, who have been running for more than a year. The respondents were divided into groups according to the favorite length of the racing race. Groups were compared in terms of nutritional supplements usage, running-related injuries, as well as the impact of Covid-19 pandemic on their running volume. Difference between groups in Exercise Addiction Inventory (EAI) questionnaire outcome scores was also accessed. RESULTS The statistical analysis included the answers of 644 people of both genders, among which 309 (48%) men and 335 (52%) women. The average age of the respondents was 42 years (18-75), and the average age of running was 5 years (1-42). Only among the respondents who started running most recently (1 to 10 years), and those who run the longest races (longer than 100 km) were found to use nutritional supplements significantly more (71.43%, P<0.001) and sustained injuries associated with running more than rest of the groups (100%, P=0.013). Due to the pandemic, only respondents who have been running for the longest time (31-42 years) and prefer to run races from 21 to 42 km significantly reduced the amount of training (75%, P=0.037). The risk for addiction was significantly positively associated with the use of dietary supplements, the favorite length of the race and the frequency of injuries, while there was no association with the length of running. CONCLUSIONS Running is a high-risk sport for addiction development. All the benevolent attitudes and positive effects of running often mask the downsides of addiction that can compromise an individual and his or her physical, mental, and social functioning. Due to the high percentage of addiction risk of 25%, it is necessary to educate the racing community to raise awareness of the negative effects of overtraining, prevent complications and seek the necessary help.
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Affiliation(s)
- Debi Živčić Tomić
- Department for Rheumatology and Rehabilitation, Clinical Hospital Centre Zagreb, Zagreb, Croatia
| | - Martina Tomić
- Vuk Vrhovac University Clinic for Diabetes and Metabolic Diseases, Mercur University Hospital, Zagreb, Croatia
| | - Filip Vuletić
- Department for Orthopedic Surgery, Sveti Duh University Hospital, Zagreb, Croatia - .,Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Goran Vrgoč
- Department for Orthopedic Surgery, Sveti Duh University Hospital, Zagreb, Croatia.,Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
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Butt U, Vuletić F, Stenhouse G, Hudetz D, Bradbury N. Meniscal scaffold for the treatment of partial meniscal defect-clinical and radiological outcomes in a two-year follow-up. Int Orthop 2020; 45:977-983. [PMID: 32949258 DOI: 10.1007/s00264-020-04811-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of meniscal scaffolds is to fill the defect, allow regeneration of meniscal-like tissues, and to prevent long-term risk of cartilage wear and tear. The aim of this study was to evaluate clinical results after two years and magnetic resonance imaging (MRI) results a year after implantation of a meniscal scaffold. METHODS Fifteen patients were recruited into a prospective, single-arm, single-center study, and treated with meniscal scaffolds as a result of segmental meniscal defect due to previous partial meniscectomy. Patients were evaluated using functional knee scores used pre-operatively and 6, 12, and 24 months postoperatively. The radiological outcome was assessed using MRI at 12 months by evaluating scaffold size, morphology, and intensity according to the Genovese grading system. Cartilage assessment was completed according to The International Cartilage Repair Society (ICRS) score. RESULTS All patients completed a follow-up of 24 months. A statistically significant increase in mean levels of all functional scores was present in all patients. On the MRI, all but one of the patients presented an incorporated meniscal implant. In most of the patients (73%), the meniscal implant was a Genovese type III. Type II and III signal intensities were present in all scaffolds when compared with the residual meniscal tissue. A stable cartilage (ICRS) status was observed in 80% of the patients compared with the pre-operative cartilage scores. CONCLUSION In our case series of patients treated with the meniscal scaffold implant, we observed good clinical results at a two year follow-up. Furthermore, MRI findings suggest that meniscal scaffolds might have a beneficial effect on articular cartilage.
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Affiliation(s)
- Umer Butt
- AO Clinic (Institute of Trauma, Orthopaedics and Sports Injury), Nazimabad No.4, Karachi, Pakistan
- Circle Bath Hospital, Bath, UK
| | - Filip Vuletić
- Department of Orthopaedic Surgery, University Hospital 'Sveti Duh', Zagreb, Croatia.
| | | | - Damir Hudetz
- Department of Orthopaedic Surgery, University Hospital 'Sveti Duh', Zagreb, Croatia
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