Latarjet may be reliable, safe for high-risk athletes with shoulder instability
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CHICAGO — The Latarjet procedure may be reliable and safe for the treatment of shoulder instability among athletes who participate in high-demand and high-risk activities, according to results presented here.
Robert A. Waltz, MD, and colleagues collected and evaluated glenoid bone loss, complications, revision surgery and patient-reported outcome measures among 64 consequence athletes with anterior shoulder instability who underwent open Latarjet with a minimum 24-month follow-up.
“Consequence athletes are defined as those who perform in high-risk, uncontrolled environments for whom an injury is likely to threaten life or livelihood and provide greater challenges to shoulder instability treatment beyond the common contact sport athlete,” Waltz said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “In this group, a recurrent instability event could be catastrophic to the individual or to those working or participating alongside them.”
Researchers defined failure as postoperative dislocation or if a patient required revision surgery.
“An additional analysis was performed looking at the number of prior dislocations, prior stabilization procedures vs. Latarjet as the primary procedure and looking at glenoid bone loss,” Waltz said.
Waltz noted 18.5% of patients underwent surgery after a single dislocation, with Latarjet performed as the primary index surgery in 46.2% of patients. Mean glenoid bone loss was 13.7%. Results showed 69% of patients dislocated while participating in a primary sport or profession.
Patients had significant improvements in patient-reported outcomes, with the minimal clinically important difference met in 66.2% of patients for the American Shoulder and Elbow Surgeons score and in 62.9% for the single numeric assessment evaluation score, according to Waltz.
“There was a 4.5% failure rate and those included one recurrent dislocation and then two who underwent revision surgery,” he said. “There were no wound or neurovascular complications.”
Waltz noted an increase in sports participation from 7.5% preoperatively to 76% postoperatively. Of the patients who continued sports participation postoperatively, 52% of patients modified their activity, according to Waltz. He noted modification occurred in 37% of patients due to the degree of challenges and danger that they encountered with their profession.
“Our subgroup analysis looked at prior stabilization procedures, which were associated with lower postoperative ASES scores and increased glenoid bone loss,” Waltz said. “We had no significant correlation between patient-reported outcome scores and glenoid bone loss with the number of previous dislocations.”
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Peebles AM, et al. Paper 694. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 22-26, 2022; Chicago.
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