Abstract
Purpose
The ideal treatment strategy for traumatic anterior shoulder instability with glenoid bone loss in young, physically active patients is still controversial. This study examines sporting activity, the ability to practice sports and the ability to return to sports after the arthroscopic Latarjet procedure.
Methods
A total of 47 physically active patients with an average age of 24.5 ± 5.9 years were included in the study and evaluated at a minimum of two years after surgical treatment using shoulder and sport-specific scores. The shoulder sport activity score, Brophy marx activity score, Athletic shoulder outcome scoring system and the SPORTS score were used to assess the ability to practice sports, the sporting activity and the ability to return to sports. To assess functional outcome and shoulder stability, the evaluation was conducted using the Western Ontario shoulder instability index, the Constant score, the American shoulder and elbow surgeon score, and the Subjective shoulder value.
Results
89.4% of the patients examined were able to perform the sport they had previously practiced after an average of 4.6 ± 2.0 months. Overhead athletes and martial arts athletes demonstrated a significantly lower return to sports rate than non-collision/non-overhead athletes (p = 0.01). With regard to sport-, instability-, or function-specific scores, no significant difference was found between patients after primary Latarjet procedure and patients after Latarjet procedure following a failed open or arthroscopic Bankart repair. All scores showed good to very good functional results on average. Two patients suffered a traumatic recurrent instability (4.1%) during the follow-up period and were therefore excluded from this study.
Conclusion
Arthroscopic Latarjet procedure presents a good surgical option, especially for young, physically active patients; it has very good clinical outcome, a high return to sports rate and a low probability of recurrent dislocation.
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References
Abdul-Rassoul H, Galvin JW, Curry EJ, Simon J, Li X (2019) Return to sport after surgical treatment for anterior shoulder instability: a systematic review. Am J Sports Med 47:1507–1515
Allain J, Goutallier D, Glorion C (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80:841–852
An VV, Sivakumar BS, Phan K, Trantalis J (2016) A systematic review and meta-analysis of clinical and patient-reported outcomes following two procedures for recurrent traumatic anterior instability of the shoulder: Latarjet procedure vs Bankart Repair. J Shoulder Elbow Surg 25:853–863
Bacilla P, Field LD, Savoie FH 3rd (1997) Arthroscopic Bankart repair in a high demand patient population. Arthroscopy 13:51–60
Balg F, Boileau P (2007) The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br 89:1470–1477
Bankart ASB (1938) Pathology and treatment of recurrent dislocation of the shoulder joint. Br J Surg 2(26):23–29
Beranger JS, Klouche S, Bauer T, Demoures T, Hardy P (2016) Anterior shoulder stabilization by Bristow-Latarjet procedure in athletes: return-to-sport and functional outcomes at minimum 2-year follow-up. Eur J Orthop Surg Traumatol 26:277–282
Bhatia S, Frank RM, Ghodadra NS, Hsu AR, Romeo AA, Bach BR Jr et al (2014) The outcomes and surgical techniques of the latarjet procedure. Arthroscopy 30:227–235
Blonna D, Bellato E, Caranzano F, Bonasia DE, Marmotti A, Rossi R et al (2014) Validity and reliability of the SPORTS score for shoulder instability. Joints 2:59–65
Boehm D, Wollmerstedt N, Doesch M, Handwerker M, Mehling E, Gohlke F (2004) Development of a questionnaire based on the constant-murley-score for self-evaluation of shoulder function by patients. Unfallchirurg 107:397–402
Boileau P, Thelu CE, Mercier N, Ohl X, Houghton-Clemmey R, Carles M et al (2014) Arthroscopic Bristow-Latarjet combined with bankart repair restores shoulder stability in patients with glenoid bone loss. Clin Orthop Relat Res 472:2413–2424
Boileau P, Villalba M, Hery JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 88:1755–1763
Bonnevialle N, Mansat P, Bellumore Y, Mansat M, Bonnevialle P (2008) Surgical treatment of anterior shoulder instability in rugby players: clinical and radiographic results with minimum five-year follow-up. Rev Chir Orthop Reparatrice Appar Mot 94:635–642
Brophy RH, Marx RG (2009) The treatment of traumatic anterior instability of the shoulder: nonoperative and surgical treatment. Arthroscopy 25:298–304
Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP (2007) Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy 23:1033–1041
Cerciello S, Edwards TB, Walch G (2012) Chronic anterior glenohumeral instability in soccer players: results for a series of 28 shoulders treated with the Latarjet procedure. J Orthop Traumatol 13:197–202
Chillemi C, Guerrisi M, Paglialunga C, Salate Santone F, Osimani M (2020) Latarjet procedure for anterior shoulder instability: a 24-year follow-up study. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-020-03426-2
Colegate-Stone TJ, van der Watt C, de Beer JF (2015) Evaluation of functional outcomes and complications following modified Latarjet reconstruction in athletes with anterior shoulder instability. Shoulder Elbow 7:168–173
Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164
Dickens JF, Owens BD, Cameron KL, DeBerardino TM, Masini BD, Peck KY et al (2017) The effect of subcritical bone loss and exposure on recurrent instability after arthroscopic bankart repair in intercollegiate american football. Am J Sports Med 45:1769–1775
Domos P, Lunini E, Walch G (2018) Contraindications and complications of the Latarjet procedure. Shoulder Elbow 10:15–24
Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res 400:65–76
Hovelius L, Vikerfors O, Olofsson A, Svensson O, Rahme H (2011) Bristow-Latarjet and Bankart: a comparative study of shoulder stabilization in 185 shoulders during a seventeen-year follow-up. J Shoulder Elbow Surg 20:1095–1101
Hovelius LK, Sandstrom BC, Rosmark DL, Saebo M, Sundgren KH, Malmqvist BG (2001) Long-term results with the Bankart and Bristow-Latarjet procedures: recurrent shoulder instability and arthropathy. J Shoulder Elbow Surg 10:445–452
Hurley ET, Montgomery C, Jamal MS, Shimozono Y, Ali Z, Pauzenberger L et al (2019) Return to play after the latarjet procedure for anterior shoulder instability: a systematic review. Am J Sports Med 47:3002–3008
Ialenti MN, Mulvihill JD, Feinstein M, Zhang AL, Feeley BT (2017) Return to play following shoulder stabilization: a systematic review and meta-analysis. Orthop J Sports Med 5:2325967117726055
Jeon YS, Jeong HY, Lee DK, Rhee YG (2018) Borderline glenoid bone defect in anterior shoulder instability: latarjet procedure versus bankart repair. Am J Sports Med 46:2170–2176
Kazum E, Chechik O, Pritsch T, Mozes G, Morag G, Dolkart O et al (2019) Biomechanical evaluation of suture buttons versus cortical screws in the Latarjet-Bristow procedure: a fresh-frozen cadavers study. Arch Orthop Trauma Surg 139:1779–1783
Kirkley A, Griffin S, McLintock H, Ng L (1998) The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. The Western Ontario shoulder instability index (WOSI). Am J Sports Med 26:764–772
Kroner K, Lind T, Jensen J (1989) The epidemiology of shoulder dislocations. Arch Orthop Trauma Surg 108:288–290
Lafosse L, Lejeune E, Bouchard A, Kakuda C, Gobezie R, Kochhar T (2007) The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability. Arthroscopy 23(1242):e1241–1245
Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49:994–997
Mazzocca AD, Brown FM Jr, Carreira DS, Hayden J, Romeo AA (2005) Arthroscopic anterior shoulder stabilization of collision and contact athletes. Am J Sports Med 33:52–60
Minkus M, Wolke J, Fischer P, Scheibel M (2019) Analysis of complication after open coracoid transfer as a revision surgery for failed soft tissue stabilization in recurrent anterior shoulder instability. Arch Orthop Trauma Surg 139:1435–1444
Mizuno N, Denard PJ, Raiss P, Melis B, Walch G (2014) Long-term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elbow Surg 23:1691–1699
Neyton L, Young A, Dawidziak B, Visona E, Hager JP, Fournier Y et al (2012) Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up. J Shoulder Elbow Surg 21:1721–1727
Potzl W, Thorwesten L, Gotze C, Garmann S, Steinbeck J (2004) Proprioception of the shoulder joint after surgical repair for Instability: a long-term follow-up study. Am J Sports Med 32:425–430
Richard JH, Bokor DJ (1998) Clinical evaluation of shoulder. In: Rockwood CA, Matsen FA (eds) The Shoulder., pp 164–197
Shin SJ, Kim RG, Jeon YS, Kwon TH (2017) Critical value of anterior glenoid bone loss that leads to recurrent glenohumeral instability after arthroscopic bankart repair. Am J Sports Med. https://doi.org/10.1177/0363546517697963
Simonet WT, Cofield RH (1984) Prognosis in anterior shoulder dislocation. Am J Sports Med 12:19–24
Stein T, Linke RD, Buckup J, Efe T, von Eisenhart-Rothe R, Hoffmann R et al (2011) Shoulder sport-specific impairments after arthroscopic Bankart repair: a prospective longitudinal assessment. Am J Sports Med 39:2404–2414
Thomazeau H, Courage O, Barth J, Pelegri C, Charousset C, Lespagnol F et al (2010) Can we improve the indication for Bankart arthroscopic repair? A preliminary clinical study using the ISIS score. Orthop Traumatol Surg Res 96:S77–83
Tibone JE, Bradley J (1993) Evaluation of treatment outcomes for the athletes shoulder. In: Matsen FA, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability, Rosemont, III, pp 526–527
Witherspoon JW, Smirnova IV, McIff TE (2014) Neuroanatomical distribution of mechanoreceptors in the human cadaveric shoulder capsule and labrum. J Anat 225:337–345
Young AA, Maia R, Berhouet J, Walch G (2011) Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint. J Shoulder Elbow Surg 20:S61–69
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Buckup, J., Sternberg, C., Smolen, D. et al. Functional outcome and return to sports after the arthroscopic latarjet procedure in young and physically active patients. Arch Orthop Trauma Surg 140, 1487–1494 (2020). https://doi.org/10.1007/s00402-020-03513-4
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DOI: https://doi.org/10.1007/s00402-020-03513-4