The role of arthroscopic Latarjet shoulder stabilization as a revision surgery after failed anterior shoulder instability repair is still a matter of debate. The aim of this study was to compare subjective and objective clinical outcomes, recurrence and complication rate of arthroscopic Latarjet revision procedure after failed arthroscopic Bankart repaire.
A comparative case-control retrospective analysis was performed including 62 patients who underwent revision shoulder stabilization using arthroscopic Latarjet technique after failed arthroscopic Bankart procedure (group 1) by the same senior surgeon, were matched with 35 patients who had initial arthroscopic Latarjet repair (group 2). Outcome measures included Rowe score, the Western Ontario Shoulder Instability Index, Constant-Murley Shoulder Outcome score and Single Assessment Numeric Evaluation. Dislocations, subluxations, complications and pre and postoperative level of activity were assessed too.
After a mean follow-up of 38 months, 55 shoulders (88,7%) were subjectively graded as good to excellent and 32 (91,4%) in the revision and the primary surgery group, respectively. No significant differences in the Rowe score (91,4 vs 94.1 points) were found between groups 1 and 2 (P =0.223) neither was found statistically significant difference in the Constant-Murley Shoulder Outcome score (90,7 vs 94,0 p=0.105). The average Western Ontario Shoulder Instability Index decreased from 1262 to 510 and from 1119 to 403 for the group 1 and 2 respectively (P=0,049).
Four recurrent dislocations were reported (6,4%) in the revision group and one in the control group (P = 0.140). In two failed cases Eden-Hybinette procedure was conducted and in remaining two patients anterior capsular reinforcement was applied.
Patients with revision shoulder stabilization had more problems in returning to previous level of sports participations than patients in the control group (p= 0.023)
Arthroscopic Latarjet procedure after failed arthroscopic Bankart provides satisfactory results as a revision surgery with good to excellent subjective patient-reported outcomes with low recurrence and complication rate. However, decreased level of sports participation can be expected.