Bristow versus Latarjet in high-demand athletes with anterior shoulder instability: a prospective randomized comparison

Abstract

Background Traumatic anterior shoulder instability is a common disease, especially in young athletes. The Latarjet and Bristow techniques are nonanatomical surgeries that involve the transfer of the coracoid process to the anterior border of the glenoid and are indicated in cases at a high risk for recurrence and in the presence of associated bone lesions. Studies have evaluated the recurrence and complications associated with these techniques, but they have important differences, and should not be considered synonymous. The objective of this study was to prospectively compare the Bristow and Latarjet techniques in high-demand athletes. Hypothesis: Bristow and Latarjet techniques lead to similar results. Patients and methods Thirty-seven athletes (41 shoulders; three athletes underwent bilateral surgery) with anterior recurrent dislocation of the shoulder that was surgically treated using the Bristow or Latarjet technique were prospectively analyzed. The follow-up time was 5 years. The mean age was 26.4 years (range: 16-46 years). In 17 cases (41.5%), the dominant side was not affected. Results Elevation and external rotation (passive and active) decreased in the early postoperative period and achieved values in the final follow-up similar to those found in the preoperative period. The mean postoperative scores at 5 years were as follows: ASES, 79.1 (range: 66-95); ASORS, 77.8 (range: 60-100); WOSI, 52.6 (range: 18-77); and VAS, 1.88 (range: 0-6). All of the results presented statistical significance. There was a complication rate of 9.75% in the follow-up period. There were no new dislocations after the surgery. Most (75%) of the athletes returned to the sport after the surgery, and there was no correlation between poor results and any of the variables studied. There was a statistically significant difference in passive external rotation in favor of the Latarjet technique four weeks after surgery ( P = .01). We also found a statistically significant difference in passive elevation in favor of the Latarjet technique eight weeks after the surgery ( P = .04). When we compared the Bristow and Latarjet techniques regarding the ASES, ASORS, and WOSI scores, we found no statistically significant difference. In the comparison regarding whether the athletes returned to sports, we found no statistically significant difference. Conclusion The Bristow and Latarjet techniques lead to good results in athletes with no new dislocation episodes and are suitable for treating patients with anterior recurrent dislocation of the shoulder. The Latarjet technique showed better results in some of the variables studied.

Evaluation of Latarjet procedure in female athletes: a 3-year follow-up prospective cohort study

“…assessed the ASORS scores in a prospective randomized trial with athletes and found a mean of 39 in the preoperative period and a mean of 88 at a 3-year follow-up period. 3 Their results are similar to those presented in our study, where the majority of patients had good to excellent scores, showing satisfactory results in this group of patients.…”

“…Regardless of the particularities of female athletes, after the Latarjet procedure, participants may recover their range of motion to similar results before surgery. 3 , 26 , 27 …”

Avaliação do posicionamento dos parafusos na cirurgia de Latarjet: Existe correlação entre paralelismo à glenoide e complicações radiográficas?*

“…As described in the modified Latarjet technique, no coracoacromial ligament repair was made in the joint capsule. 13,14 Postsurgical Tomographic Evaluation…”

Glenoid bone augmentation: a contemporary and comprehensive systematic review of open procedures

“…26 No DTA studies reported nerve-related or screwrelated complications, though it is unclear whether these were explicitly assessed. For coracoid procedures, screw-related complications were reported in over a third of studies or study arms (34/84, 4.5%) and included irritation, 64 malposition, 54 bending, 87 fracture, 34 general "irregularity," 97 and loosening 37 ; these complications occurred at low rates, but some were severe enough to require revision surgery. 23 Nerve-related injury at the site of bone augmentation was reported in 16 of the 84 coracoid bone studies (19.0%); pathologies included neuropraxia, 113 nerve palsy, 51 paresthesia, 96 and transient lesion on a nerve.…”