Satisfactory functional results and complication rates after anterior glenoid bone block reconstruction in recurrent shoulder dislocation: a mean 4-year follow-up comparative study.

BACKGROUND: Anterior recurrent instability of the glenohumeral joint is a common clinical problem among the young population. Glenoid reconstruction with bone graft has become the treatment of choice, particularly in significant deficiency (˃20%). This study aims to assess the functional results of glenoid reconstruction using Latarjet and iliac bone graft in the management of glenoid insufficiency associated with recurrent anterior dislocation of the glenohumeral joint. METHODS: Patients suffering from anterior shoulder instability with glenoid defect >20% were included in this study between 2016 and 2021. The university of California at Los Angeles (UCLA) shoulder scale and Constant score were used to assess the functional improvement. Preoperative and final postoperative continuous outcomes were compared with a one-tailed paired t-test and the outcomes across groups were compared using a two-tailed independent t-test. A P-value of <0.05 was considered statistically significant for both tests. RESULTS: This trial included 50 patients; twenty-five underwent mini-open Latarjet, and 25 underwent arthroscopic tricortical iliac crest bone grafting (ICBG). The mean follow-up durations were 50.1 ± 5.9 months for Laterjet and 51.6 ± 6.8 months for ICBG. Both techniques showed statistically significant improvement in the final UCLA (31.1 ± 2.1 in Laterjet and 30.2 ± 2.2 in ICBG) and Constant (90.2 ± 4.6 in Laterjet and 89 ± 5.01 in ICBG) scores. There was no statistically significant difference regarding mean age, sex, side of injury, mechanism of injury, follow-up period and clinical outcome between both surgical treatments. At the end of the study, both groups demonstrated statistically significant improvement in the range of motion (p Ë‚ 0.00001). Only one, non-adherent patient in Laterjet group had post-operative dislocation. In ICBG group, two patients had partial bone graft resorption, 3 graft site morbidities and 1 hardware prominence. CONCLUSION: Both Laterjet and iliac bone graft procedures had satisfactory functional results in reconstruction of glenoid defect >20% in unstable shoulders with a mean 4-year follow-up. No statistically significant difference was reported in the last postoperative Constant and UCLA scores between both techniques, but Latarjet procedure had fewer complications (4%) than ICBG (24%). LEVEL OF EVIDENCE: Prospective non-randomized comparative study; level II.

Ecology of endangered Prunus korshinskyi Hand.-Mazz. in Jabal Al-Lauz, Saudi Arabia: Plant associations, size structure, and nutritional screening.

The wild Prunus korshinskyi has a restricted distribution in small scattered areas of Jabal Al-Lauz (2580 m above sea level), a mountain in northwestern Saudi Arabia. Major objective of current study is to provide information about P. korshinskyi by analyzing its ecology in terms of floristic diversity, plant associations, environmental features, and its size structure and nutritional value. For this purpose, 12 stands of 20 m2 were selected along the Jabal Al-Lauz mountain ridge. Three plant associations and their environmental variables were identified and characterized after application of a two-way indicator species analysis (TWINSPAN), detrended correspondence analysis (DCA). And canonical correspondence analysis (CCA) as follows: VGI: P. korshinskyi-Astracantha echinus, VGII: Artemisia siberi-P. korshinskyi, and VGIII: Retama raetam-Artemisia sieberi. The edaphic factor affecting the distribution of the associations were pH, potassium and manganese content. The size class frequency distribution of P. korshinskyi shows a J-shape in spring and fall for the whole population; there was no regeneration via seed. Nutritional evaluation showed the fruits had a higher content of total carbohydrate, fats, crude protein, phosphorus, and potassium, and lower content of ash, Fe, Ca, Mn, Mg, and Zn than that in stems and leaves. This ecological knowledge gained through this study would be beneficial for managing and conserving of P. korshinskyi in a Jabal Al-Lauz area with its distinct and unique vegetation.