Sling immobilization may be optional after open Latarjet surgery for shoulder instability
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LAS VEGAS — Presented results found similar functional and pain outcomes between patients with and those without sling immobilization after open Latarjet surgery for shoulder instability.
“In [patients who undergo open Latarjet surgery], you want to avoid stiffness, especially in external rotation. You want to avoid muscular atrophy, [and] you want to return them to their daily activities as early as possible,” Patrick Goetti Sr., MD, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “But we do not know if there is a predictive effect of immobilization on complication rates,” he said.
Goetti and colleagues performed a randomized controlled trial that analyzed functional and pain outcomes of 72 patients with anterior shoulder instability who underwent an open Latarjet procedure either with or without sling immobilization. Outcome measures included Rowe, single assessment numeric evaluation (SANE) and VAS pain scores at baseline, 1.5-, 3- and 6-month postoperative timepoints. Goetti noted grafts were secured with two, threaded 4-mm cancellous screws, which were 1 cm apart from each other.
At 6 months, both groups had showed significant improvements in all outcomes. Mean Rowe scores improved from 38.8 to 81.6; mean SANE scores improved from 42.5 to 84.7; and mean VAS scores improved from 27.7 to 13.9.
Researchers found no significant differences in outcomes between the groups. Mean Rowe scores were 80.7 in the sling group and 82.6 in the no-sling group; mean SANE scores were 83.7 in the sling group and 85.7 in no-sling group; and mean VAS scores were 15.6 in the sling group and 12.2 in the no-sling group. Goetti also noted CT evaluation revealed no differences in graft healing between the groups.
“The absence of postoperative immobilization did not increase complications rates,” Goetti said. “We therefore modified our practice and stopped using sling immobilization after open Latarjet,” he concluded.
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Goetti Sr. P, et al. Paper 245. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.
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