Outcomes After Latarjet Procedure: Patients With First-Time Versus Recurrent Dislocations

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Previous studies indicate a higher recurrence and reoperation rate after Bankart repair with an increased number of preoperative dislocations.
• This is potentially due to diminished tissue quality following multiple dislocations.
• The Latarjet procedure offers a reconstructive and augmentative approach to the anterior glenoid, differing from traditional repair methods.

Purpose of the Study:

• To compare clinical outcomes of the Latarjet procedure in patients with one preoperative dislocation versus multiple (≥2) dislocations.
• To test the hypothesis that the number of preoperative dislocations does not impact clinical results after a Latarjet procedure.

Main Methods:

• A cohort study (Level of evidence, 3) included 308 patients over 18 years old who underwent a primary Latarjet procedure for shoulder instability.
• Patients had a minimum follow-up of 2 years and were assessed for dislocation recurrence, revision surgery, and functional outcomes using the Walch-Duplay score, Simple Shoulder Test, and VAS for pain.
• Three surgical techniques were employed: mini-open with 2 screws, arthroscopic with 2 screws, and arthroscopic with 2 cortical buttons.

Main Results:

• No significant differences in recurrence (4.8% vs. 3.65%) or reoperation rates (6.1% vs. 4.0%) were observed between the first-time and recurrent dislocation groups, respectively.
• Overall Walch-Duplay scores were comparable (67.3 ± 24.85 vs. 71.8 ± 25.1).
• Patients with first-time dislocations reported significantly higher postoperative pain scores (VAS: 1.8 ± 2.3 vs. 1.2 ± 1.7; P = .03) and lower pain subscores (15.0 ± 8.6 vs. 18.0 ± 7.5; P = .003).

Conclusions:

• The preoperative number of dislocations does not influence postoperative instability or reoperation rates following the Latarjet procedure.
• Patients undergoing the Latarjet procedure after their first dislocation experienced greater postoperative pain compared to those with a history of recurrent dislocations.