2023 ISAKOS Biennial Congress ePoster
Clinical Outcomes, Return To Sport, And Complications After Isolated Primary Latarjet vs. Latarjet as a Revision Procedure: A Systematic Review and Meta-Analysis
Garrett Jackson, MD, Columbia, MO UNITED STATES
Harkirat Jawanda, BS, Chicago, IL UNITED STATES
Johnathon Robert Mccormick, MD, Chicago, Illinois UNITED STATES
Enzo Salviato Mameri, MD, MSc, São Paulo, São Paulo BRAZIL
Mario Hevesi, MD, PhD, Rochester, MN UNITED STATES
Derrick Michael Knapik, MD, Chesterfield, Missouri UNITED STATES
Jorge Chahla, MD, PhD, Hinsdale, IL UNITED STATES
Nikhil N. Verma, MD, Chicago, IL UNITED STATES
Rush University Medical Center, Chicago, IL, UNITED STATES
FDA Status Not Applicable
Summary
Patients undergoing primary and revision Latarjet demonstrated overall similar rates of complications and return to sport. Of clinical importance, Latarjet as a revision procedure possessed a risk of recurrent subluxation 3.6 times higher than primary Latarjet. While effective, patients should be counseled regarding the differing prognosis between Latarjet as a primary or revision procedure.
ePosters will be available shortly before Congress
Abstract
Purpose
To compare return to sport and complications in comparative studies examining patients undergoing primary Latarjet procedure versus Latarjet in the revision setting following soft tissue stabilization.
Methods
A literature search was conducted using PubMed and Scopus databases by two independent reviewers using PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. The search included the following search terms combined with Boolean operators: ‘Latarjet’, ‘Shoulder Instability’, ‘Coracoid Transfer’, ‘Shoulder Dislocation’, ‘Failed Bankart’, ‘Revision stabilization’, and ‘Recurrent instability’. Inclusion criteria consisted of level I to III human clinical studies reporting return to sport metrics and complications in patients following primary versus revision Latarjet procedures.
Results
A total of seven studies, consisting of 1,170 patients (n=1,179 shoulders) with a mean age of 26.4 years, consisting of 91.9% males (n=1083/1179 shoulders), were identified. Mean final follow-up was 46.4 (mean range, 7.3 – 72.2) months. A total of 748 primary and 431 revision Latarjet procedures were analyzed. No significant difference was found in return to sport (RTS) rate for primary Latarjet (87.3%; range, 83.8% - 92.1%) when compared to patients undergoing revision Latarjet (78.9%%; range, 60% - 100%) (p = 0.08). Complications were reported in 9.6% (range, 0% - 24.2%) of patients undergoing primary and 20.2% (range, 0% - 40.7%) in patients undergoing revision procedures (p=0.22). Recurrent shoulder subluxation was significantly greater in patients undergoing revision (12.0%; n=31/259 shoulders; range, 0% - 20.7%) compared to primary procedures (3.3%; n=27/511 shoulders; range, 0% - 9%) (p < 0.001).
Conclusion
Patients undergoing primary and revision Latarjet demonstrated overall similar rates of complications and return to sport. Of clinical importance, Latarjet as a revision procedure possessed a risk of recurrent subluxation 3.6 times higher than primary Latarjet. While effective, patients should be counseled regarding the differing prognosis between Latarjet as a primary or revision procedure.