Summary

In adolescent patients, Open Latarjet Procedure appears to be an excellent option to treat recurrent anterior instability of the shoulder in terms of reluxation rates, and exhibits excellent outcomes similar to adults

Abstract

Aim

The aim of this study is to demonstrate the results of open primary Latarjet surgery in adolescent patients, with long-term follow-up.

Background

Recurrent anterior shoulder instability in adolescents is a difficult situation to manage when considering a surgical intervention. Anatomic procedures such as arthroscopic Bankart repair is considered the gold-standard in these young patients to preserve joint integrity. However, the incidence of reluxation after arthroscopic Bankart repair varies between 20% and 50% in young patients under 18.

Methods

We analyzed clinical data from patients under 18 years of age undergoing primary open Latarjet surgery between January 2007 and December 2021 as surgical stabilization for recurrent anterior shoulder instability. Patients excluded from the study were patients older than 18 years, patients who had undergone other types of surgery for instability and those who had previously undergone shoulder surgery. 143 shoulders were eligible. 125 Open Latarjet, 2 arthroscopic Latarjet and 16 arthroscopic Bankart repairs. At the end of the study period (June 2023), medical notes and a final telemedicine interview were used to determine whether patients had experienced any recurrences or complications or reoperations. The Return to sport rate, The Walch and Duplay, the VAS score and Satisfaction were collected for all patients. We considered recurrence to be acceptable at less than 5%.

Results

Mean follow-up was 6 years and 5 months. A new episode of instability occurred in 4% in the Latarjet group. The functional score Walch and Duplay was 69± 36 (range 0.0 to 100.0), SSV was 88 ± 12 (range 30.0 – 100.0), SANE was 91. ± 14 (range 40.0 - 100.0) and VAS was 0.6 ± 1.3 (range 0.0 – 7.0). Return to Sport rate was 65%, satisfaction rate was 95% and Revision surgery was 0,6%.

Conclusion

The non-anatomic Latarjet procedure exhibits excellent outcomes in adolescents patients similar to adults. Latarjet is therefore a valuable option in adolescents.