Background: Although the congruent arc Latarjet procedure has shown to be an effective treatment for the management of recurrent glenohumeral instability in the short term, there are no studies in the literature evaluating its long-term results.
Purpose: The objective of the following study was to evaluate the functional outcomes, complications and revisions of a consecutive series of athletes with recurrent glenohumeral instability treated with the Congruent Arch Latarjet procedure with a minimum follow-up of 10 years.
Study design: Retrospective cohort study
Methods: Between June 2008 and April 2012, 106 athletes with recurrent glenohumeral instability were treated at our institution with the congruent arc Latarjet procedure. In total, 63 revision procedures and 43 primary procedures were included. We evaluated Return to sport and used the ROWE, EVA, ASOSS and SANE scores to assess functional outcomes. Complications and revisions were evaluated. Graft consolidation was evaluated with CT at 3 months. Osteoarthritis was evaluated at the final follow-up with radiographs according to the Samilson Prieto classification.
Results
The final analysis included 90 patients (Follow-up 91%). The average follow-up was 140 months (120-158 months) and the average age at the time of surgery was 23.2 years (range 17-35 years). Overall, 94% of patients returned to sports and 90% returned to the same level as before surgery. At the last follow-up, 40% of the patients had changed sports or abandoned sports. No patient reported having left the sport for reasons related to the shoulder. The two main causes of abandonment referred to were labor demand (50%) and studies (30%). The mean Rowe, VAS, and ASES scores at 140-month follow-up were 85, 1.5, and 80, respectively, all improved significantly compared to the preoperative (P < .01). The average SANE score was 85%. Moreover, 94% and 96% of the patients had a Rowe and ASES score that exceeded the MCID, respectively. The bone graft consolidated in 90% of the patients. The recurrence rate was 5.5% and the revision rate was 3%. At the end of follow-up, 20% of the patients had osteoarthritic changes. (10% mild, 6% moderate and 4% severe). There were no significant differences in functional scores between patients who presented arthritic changes and those who did not.
Conclusion
The Congruent arc Latarjet procedure is associated with a high percentage of return to sport, excellent functional outcomes and a low rate of recurrences after a minimum follow-up of 10 years. Although 20% of patients had osteoarthritic changes at the end of follow-up, most were mild and moderate, without significant differences in functional scores between patients who presented arthritic changes and those who did not.