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Outcomes Of Arthroscopic Latarjet As A Revision Procedure For Treatment Of Recurrent Anterior Shoulder Instability After Failed Arthroscopic Bankart Repair. A Case Series

Outcomes Of Arthroscopic Latarjet As A Revision Procedure For Treatment Of Recurrent Anterior Shoulder Instability After Failed Arthroscopic Bankart Repair. A Case Series

Lika Dzidzishvili, MD, PhD, SPAIN Claudio Calvo Palma, MD, PhD, CHILE María Valencia Mora, MD, PhD, SPAIN Antonio Foruria, MD, PhD, SPAIN Emilio Calvo, MD, PhD, MBA, SPAIN

Hospital Universitario Fundación Jiménez Díaz, Madrid, SPAIN


2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis Method

Sports Medicine

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Summary: Arthroscopic Latarjet procedure after failed arthroscopic Bankart repair provides good to excellent clinical outcomes as a revision surgery


Background

The role of arthroscopic revision shoulder stabilization after failed anterior shoulder instability repair is still a matter of debate. To our best knowledge, there are no studies describing outcomes of arthroscopic Latarjet as a revision surgery for anterior shoulder instability after failed arthroscopic Bankart repair.

Objective

The main goal of this study was to assess subjective and objective clinical outcomes, recurrence and complication rates of arthroscopic Latarjet as a revision procedure after failed arthroscopic Bankart repair.

Methods

Between 2009 and 2018, 62 patients with either one (n = 46), two (n =12), or three (n = 4) arthroscopic previous stabilizations underwent revision surgery using arthroscopic Latarjet technique. Clinical outcomes at a minimum of 38 months postoperatively included Rowe score, the Western Ontario Shoulder Instability Index, Constant-Murley Shoulder Outcome score and Single Assessment Numeric Evaluation. Dislocations, subluxations, complications, pre and postoperative level of activity were assessed.

Results

Fifty-five shoulders (88.7%) were subjectively graded as good to excellent using Single Assessment Numeric Evaluation. The mean Rowe and Constant-Murley Scores increased from 43.7 to 94.1 (p<0.001) and from 47.7 to 94 (p=0.032), respectively. Western Ontarioa Shoulder Instability Index decreased from 1262 to 510 at the final follow-up (p=<0.001). Four recurrent dislocations were reported (6.4%). In two failed cases an Eden-Hybinette procedure was conducted as bone block osteolysis was observed and in remaining two patients extraarticular anterior capsular reinforcement was performed. One case of fracture of the transferred graft and a single case of graft non-union were found; in both cases have no significant influence on the clinical result. One case of stiffness was reported and was resolved with rehabilitation and self-stretching exercises. No neurological complication was recorded. Patients had more problems in returning to previous level of sports participations (p= 0.017).

Conclusions

Arthroscopic Latarjet procedure after failed arthroscopic Bankart repair seems to provide a satisfactory option as a revision surgery with good to excellent objective as well as subjective patient-reported outcomes with low recurrence and complication rates. However, no improvement in postoperative level of sports participation was observed.


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