Summary

A summary of clinical outcomes from a large single surgeon arthroscopic Latarjet case series.

Abstract

Aim

The aim of this study is to evaluate the clinical and radiological outcomes following arthroscopic Latarjet stabilization procedure with a capsule-labral reconstruction with up to 24 month follow-up.

Background

A modified arthroscopic Latarjet procedure including repair of the anterior capsule enhances construct stability and has demonstrated favorable clinical results at 2 years post-surgery. However, a comprehensive assessment of clinical and radiological outcomes for this modified technique is lacking in literature. This study examines a large single surgeon cohort with more than 300 patients over 2-years of follow-up.

Method

Patients were prospectively and consecutively recruited from a single center, single surgeon cohort. All underwent arthroscopic Latarjet stabilization with capsule-labral repair between December 2011 and July 2022. Primary outcome was recurrence of dislocation, with secondary outcomes WOSI, ASES, QuickDASH, OSIS, Constant-Murley scores, ROM, and pain. Assessments occurred pre-operatively, at 6 weeks, 3 months (with radiology if no bone union observed at 6-week CT), 12 months, and 24 months post-op, evaluating clinical scores, complications, and radiological outcomes including bone union, graft position, osteolysis.

Results

From February 2011 to 2022, 316 patients were consecutively included, with 277 reaching 12-month follow-up. The self-reported dislocation recurrence rate was 2.2% (6 out of 273 cases). Mean forward flexion improved from 153.7 to 169.7 at 12 months (p<0.002), while mean abduction improved from 148.9 to 167.3 (p<0.018). External rotation showed no significant change 12 and 24-months post-operatively (pre-op 55°, 12 months 55°, and 24 months 53°, p>0.10 ). WOSI significantly improved from 1314.8 to 506.9 at 12 months and 456.5 at 24 months (both p<0.001). ASES significantly improved from 59.7 to 84.7 at 12 months and 88.4 at 24 months post-operative (both p<0.001). The Constant score significantly improved from 62.7 to 79.9 at 12 months and 80.6 at 24 months post-operative (both p<0.001). The overall complication rate was 9.5%, including 10 hardware removals (3.2%), 3 neurological injuries (1.1%), and 4 infections. Bone union was achieved in 96.4% of patients at 12 months follow-up, with 95% of grafts positioned below the equator.

Conclusion

At 12 and 24 months post-surgery, clinically and statistically significant functional improvements were seen with VAS, DASH, ASES, Constant, WOSI and EQ5D health. These results indicate that arthroscopic Latarjet with capsular repair resulted in a clinically meaningful change in patient's functional outcome. The results shows that, although the arthroscopic Latarjet is a complex procedure, it can be performed with excellent functional and radiological outcomes. Complications are in line with previous published literature.