Summary

In contrast to previously reported complication rates of up to 25% following Latarjet, this study suggests that patients who undergo Latarjet for anterior shoulder instability have an overall early complication rate of 10%, with recurrent instability the most common complication.

Abstract

Background

The utilization of the Latarjet procedure for the treatment of anterior shoulder instability has increased over the past two decades. Relatively little data on short-term complication rates following Latarjet is available, though some authors have reported complication rates as high as 25%. The purpose of this study was to describe the rate and type of complications occurring within 90-days following the Latarjet procedure for anterior glenohumeral instability.

Methods

A total of 77 consecutive patients (77 shoulders) underwent the Latarjet procedure for anterior glenohumeral instability by fellowship-trained surgeons from a single institution between 2007-2014. Indications for Latarjet included primary or recurrent anterior instability with clinically significant anterior glenoid bone loss and/or failed prior arthroscopic stabilization. Patients undergoing Latarjet after prior glenoid bone grafting were excluded. All complications that occurred within 90 days of surgery were analyzed and correlated with demographic factors.

Results

Of the 77 patients, 7 were lost to follow-up, for an overall follow-up rate of 91%. Of the remaining 70 patients (average age 28.6±12.2 years, 70% male), there were 7 complications within 90 days of surgery, for an overall short-term complication rate of 10.0%. Three of these 7 required subsequent surgery, including 2 for recurrent instability (overall rate of 2.85%) and 1 for infection (overall rate of 1.4%). The two patients who experienced recurrent subluxation events each ultimately required conversion to arthroplasty, including hemiarthroplasty in 1 case at 8 months (50 year old female) and total shoulder arthroplasty in the other case at 6 months (45 year old female). The one patient (22 year old male) who sustained a deep infection underwent subsequent irrigation and debridement followed by 8 weeks of antibiotic therapy for P. acnes, with resolution of infection. The remaining 4 complications were transient, resolving with nonoperative treatment, including wound dehiscence (N=1, 25 year old male, resolved with oral antibiotics), complex regional pain syndrome (N=1, 26 year old male, resolved with pain management consultation), ulnar neuritis (N=1, 22 year old male, resolved within 2 months), and postoperative pain requiring subacromial steroid injection (N=1, 27 year old female, resolved within 3 months). The 63 patients without complications had an average age of 28.3±12.3 years (71% male), with 48 (76%) having a history of 1 or more prior shoulder stabilization procedures. The 7 patients experiencing complications had an average age of 31.0±11.6 years (57% male), with 4 (57%) having a history of 1 or more prior shoulder stabilization procedures. No cases of hardware failure, graft osteolysis, or other neurovascular injuries were reported.

Conclusions

The overall 90-day complication rate following Latarjet for anterior shoulder stabilization is 10%, substantially lower than the previously described rate of 25%. In 3 cases, complications led to subsequent surgery, including 2 conversions to arthroplasty, while in the remaining 4 cases, the complications were transient and resolved with non-operative treatment. This information can be used to counsel patients on the risks of early complications following Latarjet.