Summary

our study, confirm that screw removal after Latarjet surgery does not substantially impact functional outcomes, validating it as a minor complication. The screw removal group displayed lower patient satisfaction and reduced return to sports activity, along with a tendency towards higher apprehension without significant redislocation rates.

Abstract

Background

Recurrent anterior shoulder instability often requires surgical intervention, with two prominent approaches: anatomical (e.g., Bankart) and non-anatomical (e.g., Latarjet) techniques. While English-speaking countries favor Bankart, Latarjet offers advantages such as quicker recovery and lower redislocation rates. On the other hand, complications include anterior pain due to an impingement between hardware and soft tissue, resolved through screw removal.
Purpose/Hypothesis: We suggest that Screw Removal doesn’t significantly impact functional outcomes, considering it a minor complication. This study's first end point is to assess W&D score for functional outcomes, and the second end point is to examine SSV, SANE, VAS scores, Satisfaction, and Return to Sport rate.
Study Design: Cohort study; Level of evidence 3.
Materials & Methods: We analyzed radioclinical data from a single-operator series of 692 shoulders treated for anterior instability with Latarjet technique between 2007 and 2021. We excluded those who underwent revision surgery, previously operated on the shoulder, and with concomitant shoulder injuries. 530 shoulders were eligible. Matching yielded 41 pairs of shoulders split between the Screw Removal and No Revision group.

Results

At a mean follow-up of 85.0 months the functional score Walch and Duplay was respectively 76 ± 19 (MEDIAN, 80; range, 15.0 to 100.0) and 81 ± 22 (median, 85; range, 0.0 to 100.0) ) in patients for No Revision and Screw Removal (p = 0.151), SSV was respectively 82 ± 15 (median, 85; range, 40.0 – 100) and 86 ± 14 (median, 90 ; range 40.0 - 100.0) ) (p = 0.137), SANE was respectively 89 ± 19 (median, 100 ; range 0.0 - 100.0) and 89 ± 14 (median, 95 ; range 50.0 to 100.) (p=0.158)) and VAS were respectively 0.7 ± 1.3 (median, 0 ; range, 0 - 5) and 1.1 ± 1.5 (median, 1; range 0 – 5)(p=0.062). Satisfaction and Return to Sport rate were statistically significant lower in the Screw Removal group (p = 0.026 and p = 0,04 respectively).
Conclusion; Our results confirm that screw removal after Latarjet surgery does not substantially impact functional outcomes, validating it as a minor complication.