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Outcomes of arthroscopic cortical-button Latarjet procedure with minimum 5-year follow-up
Joana Pelletier1, Hugo Barret1, Yoann Dalmas1
1Orthopedic Trauma Department, University of Toulouse Hospital Center, Riquet Hospital, Toulouse, France; University Sports Clinic, Toulouse, France.
Background:
The surgical treatment of anterior shoulder instability with arthroscopic cortical-button Latarjet procedure has been the subject of very few medium and long-term studies. The aim of this study was to analyze the clinical and radiologic results of arthroscopic cortical-button Latarjet procedure with minimum 5 years follow-up.
Method:
This is a monocentric retrospective study including 40 patients who have undergone shoulder stabilization with primary arthroscopic cortical-button Latarjet procedure and been reviewed with minimum 5 years follow-up. The average age at the time of surgery was 26.6 years (16-59; ±10) and 92.5% were sporty individuals. The average Instability Severity Index score was 6 points (2-9; ±1.6). The clinical evaluation involved active range of motion measurement, apprehension test, Rowe and Walch-Duplay scores, Subjective Shoulder Value and Net Promoter Score. Radiologically, evolution of the bone graft and degenerative arthritis of the shoulder joint were analyzed at the last follow-up.
Results:
At an average follow-up of 71 months (60-97; ±12), 3 patients (7.5%) experienced recurrence as a dislocation or subluxation, which was responsible for revision in 1 case. Moreover, apprehension persisted in 6 (16%) patients. There were no significant restrictions in recovery of active ranges of motion, including external rotation. Return to sports was effective in 94.6% of cases. The average Rowe and Walch-Duplay scores were 87 points (15-100; ±20) and 88 points (15-100; ±19) respectively. Subjective Shoulder Value was 91% (10-100; ±16) and NET Promoter Score was 9.3 points (5-10; ±1,3). Radiologically, degenerative arthritis occurred in 18.7% of patients, mainly asymptomatic stage 1 (9.4%). Bone healing was acquired in 72% of cases and partial lysis of the bone block in 41%.
Conclusion:
At an average follow-up of 6 years, arthroscopic cortical-button Latarjet procedure is effective, enabling return to sport in 95% of cases. Onset of asymptomatic arthritis seems similar to conventional techniques but justifies a longer-term follow-up.
