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Long-Term Results of Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability


Naoko Mizuno, MD
JAPAN

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Long-Term Results of Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability

Naoko Mizuno, MD, JAPAN Patrick J. Denard, MD, UNITED STATES Patric Raiss, MD, GERMANY Gilles Walch, MD, FRANCE

Centre Orthopedique Santy, Lyon, FRANCE

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Anatomic Location

Shoulder Glenohumeral

Anatomic Structure

Bones

Diagnosis / Condition

Instability

Diagnosis Method

X-ray

Sports Medicine

Sport Specific Injuries Outcome Studies

Treatment / Technique

Repair / Reconstruction

Summary: Latarjet procedure for anterior glenohumeral instability provides excellent long-term results. The prevalence of postoperative development of arthritis is 17.6% at 20 years follow-up, but no severe arthritis like stage 4. Arthritic risk factors were old age at final follow-up, high demand sports activity after surgery and lateral overhang of coracoid bone graft.

Purpose

The purpose of this study was to evaluate the long-term results of Latarjet procedure and determine the prevalence and risk factors of glenohumeral arthritis.

Materials And Methods

Three hundred and thirty-four Latarjet procedures performed between 1988 and 1993 for the treatment of anterior glenohumeral instability. A retrospective review was available for 60 patients (68 shoulders). The mean age at the time of surgery was 29.4 years. The mean age at final follow-up was 48.6 years. The mean follow-up period was 20 years. All patients had a clinical and radiographic evaluation preoperatively and postoperatively. Clinical results were evaluated with Rowe score, Subjective Shoulder Value (SSV) and recurrence. Radiographic sign of arthritis was evaluated with the classification of Samilson-Prieto.

Results

At final follow-up, the mean Rowe score increased from 37.9 to 89.6 (p<0.0001). The mean SSV was 90.9%. Forty-one patients had no pain, 18 had pain during athletic activities, and 9 had pain during activities of daily living. Postoperative recurrence occurred in 4 of 68 shoulders (5.9%), with dislocation in 2 shoulders (2.9%) and subluxation in 2 shoulders (2.9%). The preoperative incidence of arthritis was 11.8% (8 shoulders, all Stage 1). Postoperative arthritis in patients without any preoperative arthritis occurred in 12 shoulders (17.6%) and progression of preoperative arthritis occurred in 4 shoulders (5.9%), which was stage 1 in 6 shoulders (8.8%), stage 2 in 4 (5.9%), stage 3 in 6 (8.8%) and no stage 4. Arthritic risk factors were old age at final follow-up (P=0.048), high demand sports activity after surgery (P=0.0003) and lateral overhang of coracoid bone graft (P<0.0001).

Conclusion

Latarjet procedure for anterior glenohumeral instability provides excellent long-term results. The prevalence of postoperative development of arthritis is 17.6% at 20 years follow-up, but no severe arthritis like stage 4.