Shoulder arthroplasty following a previous Latarjet procedure

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Musculoskeletal Research

Background:

• Shoulder arthroplasty following Latarjet procedures presents significant surgical challenges due to anatomical alterations.
• Prior Latarjet surgery can complicate subsequent shoulder replacement, affecting outcomes and implant survival.

Purpose of the Study:

• To compare clinical outcomes, complication rates, and implant survival of different shoulder arthroplasty types (HA, aTSA, rTSA) in patients with a history of Latarjet surgery versus matched controls.
• To evaluate the effectiveness of various shoulder arthroplasty techniques in a complex patient population.

Main Methods:

• Retrospective analysis of 69 patients: 23 post-Latarjet and 46 matched controls.
• Comparison of range of motion, functional scores (Constant-Murley Score, Subjective Shoulder Value), complications, revisions, and radiographic findings.
• Kaplan-Meier analysis for reintervention-free survival.

Main Results:

• Hemiarthroplasty (HA) in post-Latarjet patients showed significantly reduced improvement in flexion, abduction, and external rotation compared to controls.
• Reverse total shoulder arthroplasty (rTSA) demonstrated the highest reintervention-free survival (84.6%) at 60 months, significantly better than HA (25%).
• Complication rates varied: HA (75%), aTSA (33.3%), rTSA (15.4%) in the post-Latarjet group.

Conclusions:

• Reverse total shoulder arthroplasty (rTSA) appears to be the most reliable option for shoulder replacement after a Latarjet procedure, offering lower complication and revision rates.
• While range of motion may be reduced in post-Latarjet patients, rTSA provides superior implant survival and potentially better functional outcomes in this challenging cohort.
• The study highlights rTSA as a preferred surgical choice for patients with prior Latarjet surgery requiring shoulder arthroplasty.