The open Latarjet surgery is an established treatment but there is limited literature regarding the outcomes of this procedure with concurrent rotator cuff repair. In this study, we compared the outcomes of patients older than 40-years-old who underwent open Latarjet procedure and rotator cuff repair with those who underwent open Latarjet procedure alone.
71 patients were included in this study with a mean age at surgery of 47.6 years (40 – 67). 22 had associated full thickness cuff tears (31%) that were completely repaired during the Latarjet procedure (RCR group), and 49 did not have cuff tear (No-RCR group). Clinical outcomes were assessed by Walch-Duplay and Rowe scores, Subjective Shoulder Value. Radiographs were reviewed for osteoarthritis (OA), complications.
At a mean follow up of 10.7 years (2.4 – 21 years), apart from persistent mild pain (VASp: 1.6 ±1.9) and/or stiffness in the RCR group (59% vs 17% in No-RCR group; p<0.001), we did not observe any significant difference in the overall range of motion, functional scores and satisfaction between the 2 groups. Return to sport activities was significantly lower in the RCR group (50% vs 82% in the No-RCR group; p=0.037). Two patients (4%) in the No-RCR group and two patients (9%) in the RCR group had a recurrence of instability (p=0.24). Another 5 patients (10%) in the No-RCR group described persistent subjective apprehension. Postoperative complication rates were not different between the 2 groups: 32% in the No-RCR group vs 22% in the RCR group (p=0.51), nor was the reoperation rate (8% vs 14%, p=0.17). We did not observe any difference in the radiological outcomes.
Patients who require rotator cuff repair at the time of open Latarjet procedure can have comparable good clinical outcomes. Return to sport is lower and patients may have increased pain and/or stiffness post-operatively.