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Latarjet yielded better outcomes vs distal tibia allograft for recurrent anterior shoulder instability
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CHICAGO — Although patients with recurrent anterior shoulder instability experienced high levels of satisfaction, return to sport and improvement in clinical outcomes after glenoid reconstruction with either distal tibia allograft or a latarjet procedure, results presented at the American Shoulder and Elbow Surgeons Annual Meeting showed latarjet led to better return to contact sports.
Gregory P. Nicholson, MD, and colleagues matched patients with recurrent anterior shoulder instability undergoing distal tibia allograft with patients undergoing latarjet by age, BMI, number of previous procedures before the index procedure and participation in sports. Researchers evaluated preoperative 3-D reconstructions of CT scans for glenoid bone loss, glenoid track and humeral bone loss, and patients completed a detailed sports survey.
Patients who underwent latarjet experienced better return to the same level or better intensity of sport and better return to contact sports compared with the distal tibia allograft graft group, according to Nicholson. He also noted patients who underwent latarjet had better subjective feeling of instability.
“We did a multivariate analysis of this issue and you look at correlations with distal tibial allograft [and] latarjet, what we saw was that [for] return to contact sports, distal tibial allograft was not as good as latarjet,” Nicholson said.
Although latarjet had slightly better results among patients who underwent a number of previous surgeries, Nicholson noted the number of surgeries correlated with poorer results in both groups.
“Both did poorly with return to throwing sports,” Nicholson said. – by Casey Tingle
Reference:
Liu JN, et al. Paper 3. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 12-14, 2018; Chicago.
Disclosure: Nicholson reports he is a board or committee member for the American Shoulder and Elbow Surgeons; is a paid presenter or speaker for Arthrosurface; received IP royalties from Innomed and Wright Medical Technology Inc.; and is a paid consultant for Tornier and Wright Medical Technology Inc.