Effect of Preoperative Bone Defect Severity on Results After Latarjet Procedure: A Comparative Cohort of 310 Patients With a Minimum Follow-up of 5 Years.

BACKGROUND

There is a lack of studies in the literature evaluating the influence of the severity of the preoperative glenoid bone loss on the results of the Latarjet procedure.

PURPOSE

To compare functional outcomes, return to sport, and complications in a consecutive series of athletes undergoing Latarjet surgery for glenohumeral instability by dividing patients for analysis into 3 groups according to the severity of glenoid bone loss (GBL) (group 1, GBL between 0% and 10%; group 2, GBL between 11% and 20%; group 3, GBL >20%).

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

A comparative retrospective cohort study was performed in a consecutive series of competitive athletes with anterior glenohumeral instability who underwent surgery between January 2014 and January 2019. The clinical assessment included range of motion, Rowe score, American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS), Athletic Shoulder Outcome Scoring System (ASOSS), and return to sports. Graft consolidation was assessed by 3D computed tomography in all patients. All intraoperative and postoperative complications were documented. All results were compared between the 3 groups of patients.

RESULTS

A total of 310 patients were evaluated (n = 120 in group 1, n = 105 in group 2, and n = 85 in group 3). The mean follow-up was 8.3 years (range, 6.3-9.9 years) and the mean age was 22.1 ± 3.69 years. Range of motion and Rowe, ASES, VAS, and ASOSS scores showed significant improvement after surgery ( < .001). No statistically significant differences were found in range of motion pain or functional scores in relation to the severity of the preoperative GBL. In total, 286 patients (92%) returned to sport, and of these, 259 patients (90%) were able to return to competition at their preinjury level. The overall mean interval between surgery and return to sport was 5.4 months (range, 3-7 months). In total, 48 complications (15%) and 11 reoperations (3.5%) were noted, with no significant differences between groups. The control 3D computed tomography was performed at a mean of 3.4 months. The graft consolidated in 94.5% of patients. At the end of follow-up, 11% of patients had mild-stage osteoarthritis and 6% had moderate-stage osteoarthritis with no significant differences between groups.

CONCLUSION

The majority of athletes with recurrent glenohumeral instability who underwent Latarjet surgery returned to sport at their preinjury level, with complete recovery of shoulder function and a similar percentage of complications regardless of the severity of the preoperative GBL.