Summary
Latarjet does not obtain better results over repeated soft tissue stabilization procedures in revision shoulder instability
Abstract
Purpose
To verify the hypothesis that Latarjet is superior over soft tissue procedures for treating postoperative glenohumeral instability.
Material And Methods
Thirty-four consecutive patients (28,8±1,7 years) underwent arthroscopic revision shoulder instability repair after failed Bankart repair (subluxation or dislocation). Thirteen patients were revised with arthroscopic revision soft tissue repair (Bankart plus capsular shift or remplissage), and 21 with arthroscopic Latarjet. The findings at revision surgery were recorded. Patients were evaluated at a minimum of two-years follow-up with the Rowe, WOSI and Subjective Shoulder Value scores. Range of movement was documented. Those cases with postoperative subluxation or dislocation were considered failures.
Results
Both groups were homogeneous regarding age, gender, activity level and the presence of hiperlaxity or bony lesions. Capsular shift was added to Bankart repair in eight patients, a “remplissage” in two, and a rotator interval closure in one. No additional procedures to arthroscopic Latarjet were performed. At a mean follow-up of 27,4 months no significant differences were found between the two groups neither in the Rowe (74,2±26,3 vs 87,1±17,2), WOSI (818,3±55,2 vs 717,1±41,3) and subjective shoulder value (68,5±20,7 vs 75±18,2) scores, nor in the recurrence rate (15,4% vs 14,3%). Average loss of passive external rotation measured at 0 and 90 degrees abduction was similar (12º vs 14,6º and 13,7º vs 10,1º). Revision surgery was needed in two patients after soft tissue stabilization and in all 4 after arthroscopic Latarjet.
Conclusion
In patients with recurrent anterior shoulder instability after Bankart repair arthroscopic Latarjet does not obtain superior results over repeated soft tissue stabilization procedures.