Summary

most of the athletes with recurrent glenohumeral instability who underwent either classic or congruent arc Latarjet surgery were able to return to sports at the same level they had prior to injury with full recovery of shoulder function and a similary rate of complications, regardless of the surgical technique used.

Abstract

The purpose of this study was to compare return to sports, functional outcomes and complications of the “classic Latarjet” vs the “congruent arc Latarjet” procedures in athletes with recurrent glenohumeral instability and glenoid bone deficiency.

Methods

An analytical observational study was conducted with two retrospective cohorts of athletes with recurrent glenohumeral instability and glenoid bone deficiency who underwent surgery at our institution: (1) Cohort who underwent “classic” Latarjet surgery (January 2010 – December 2014); (2) Cohort who underwent “congruent arc” Latarjet surgery (January 2015 – May 2017). We evaluated return-to-sport, the sport level achieved and the time elapsed from surgery to return to competition. For the functional assessment of the shoulder, we measured the range of motion (ROM), the Rowe score, the visual analogue scale and the ASOSS score. Consolidation and correct positioning of the graft were evaluated by means of 3D computed tomography in all patients. All intraoperative and postoperative complications were documented. All the results were compared between the two patient cohorts.

Results

A total of 270 patients were evaluated; 150 (55.6%) were operated on using the congruent arc Latarjet technique and 120 (44.5%) were operated on using the classic Latarjet technique. The average follow-up period was 41.2 months (range of 24-90 months). Eighty-nine percent of the patients were able to return to sports and, of these, 91% were able to compete again at the same level. The global average interval between surgery and return to sports was 5.4 months. We found no significant differences in terms of the return-to-sport rate, the level achieved or the return-to-sport time among the groups operated on with either the congruent arc or the classic Latarjet surgeries. Range of motion, the Rowe score, the visual analogue score (VAS) and the ASOSS score showed significant improvement after surgery (P<0.001). We found no statistically significant differences in the range of motion nor in the functional scores between the patients who underwent the classic Latarjet surgery and those operated on with the congruent arc technique. In total, there were 40 complications (14.8%) and 10 reoperations (3.7%). No significant differences were found in terms of percentage of complications and reoperations between the two types of surgery. The follow-up 3D tomography was performed at an average of 3.4 months. The graft consolidated in 92.6% of the patients. From the axial view, 90.7% of the grafts were within the expected range (-5mm to +3mm). In contrast, 5% of the grafts were medialized and 4% were lateralized. At the end of the follow up period, 10% of the patients had mild arthrosis and 5.5% exhibited moderate arthrosis.

Conclusion

In conclusion, most of the athletes with recurrent glenohumeral instability who underwent either classic or congruent arc Latarjet surgery were able to return to sports at the same level they had prior to injury with full recovery of shoulder function and a similary rate of complications, regardless of the surgical technique used.