Clinical outcomes following revision anterior shoulder stabilization: arthroscopic revision stabilization vs. latarjet

Frank, Rachel M.; Mellano, Christopher R.; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randy; Yanke, Adam B.; Bach, Bernard R.; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

doi:10.1016/j.jse.2016.07.052

Cited by 2 publications

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“…After eliminating duplicates and screening titles and abstracts, 39 were assessed for eligibility. Of these 39 studies, 29 were excluded [ 3 , 4 , 8 – 10 , 14 , 16 , 17 , 19 , 21 , 26 , 28 , 30 – 35 , 38 , 40 – 42 , 46 – 48 , 54 , 55 , 58 , 59 ]. Ten studies were included in final qualitative synthesis and, finally, six of which [ 2 , 18 , 20 , 24 , 25 , 52 ] were not taken into consideration because the databases were not available.…”

Section: Resultsmentioning

confidence: 99%

Low grade of osteoarthritis development after Latarjet procedure with a minimum 5 years of follow-up: a systematic review and pooled analysis

Menon

Fossati

Magnani

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this systematic review and pooled analysis was to evaluate incidence and risk factors for glenohumeral osteoarthritis (OA) in patients who underwent Latarjet procedure with a minimum of 5-year follow-up. Methods The PRISMA guidelines were followed to perform this systematic review. PubMed and EMBASE were searched up to February 29, 2020 for English, human in vivo studies that evaluated glenohumeral OA in patients undergoing Latarjet procedure at least 5 years after surgery. A pooled analysis on the included databases sent by authors was performed to evaluate the risk factors influencing the development or progression of dislocation arthropathy after the Latarjet procedure. Results Four studies, including a total of 280 patients (213 males and 67 females), were analysed. In our study population, the median age at surgery was 25.0 years (range 20.8–32.6 years). and 92.1% were athletes. In 90% of the cases, the number of dislocations before surgery were fewer than 5. The recurrence of instability after Latarjet procedure was observed only in seven patients (2.5%). The position of the bone graft resulted flush to the anterior glenoid rim in 238 cases (85.3%), medial in 8 (2.9%) and overhanging in 33 (11.8%). Radiological signs of development or progression of shoulder OA were observed in 25.8% of the patients, of which 88.6% presented a grade 1 of OA according to Samilson and Prieto classification. The overhanging position of the bone graft resulted statistically significant for onset or worsening of OA. The age at surgery, the number of dislocations before surgery and the Hill–Sachs lesion were not significantly associated with joint degeneration. Instead, hyperlaxity showed a prevention role in the development of OA after open Latarjet procedure. Conclusion The Latarjet procedure is a valid and safe surgical treatment in recurrent anterior shoulder instability with a low risk of developing moderate or severe OA also at long-term follow-up. The overhanging position of the bone graft represents the principal risk factor of joint degeneration, whereas the hyperlaxity seems to be protective. Finally, age, gender, time between first dislocation and surgery, and number of dislocations do not seem to affect the onset of OA after Latarjet procedure. Therefore, an accurate execution of the Latarjet procedure can be considered a valid treatment even in young and athletes thanks to the low recurrence rates and the low development of major long-term complications. Level of evidence IV.

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Section: Resultsmentioning

confidence: 99%

Low grade of osteoarthritis development after Latarjet procedure with a minimum 5 years of follow-up: a systematic review and pooled analysis

Menon

Fossati

Magnani

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“… a Frank et al 19 included both arthroscopic repair and Latarjet procedures. NR, not reported. b Rate of recurrent instability included apprehension, subluxations, and frank dislocations. …”

Section: Resultsmentioning

confidence: 99%

“…Frank et al 19 reported clinical outcomes after revision arthroscopic stabilization compared with a revision Latarjet procedure. A total of 90 patients (91 shoulders) who had failed prior soft tissue stabilization were included.…”

Section: Resultsmentioning

confidence: 99%

“…40,43 There were a total of 3 reoperations: irrigation and debridement of septic arthritis, an intra-articular screw requiring removal, and recurrent instability treated with open capsular shift. 40,43 Outcomes Comparing Revision Arthroscopic Repair With Revision Latarjet Procedure Frank et al 19 reported clinical outcomes after revision arthroscopic stabilization compared with a revision Latarjet procedure. A total of 90 patients (91 shoulders) who had failed prior soft tissue stabilization were included.…”

Section: Outcomes Of Revision Open Bankart Repairmentioning

confidence: 99%

“…Outcomes of Revision Anterior Shoulder Stabilization aFrank et al19 included both arthroscopic repair and Latarjet procedures. NR, not reported.…”

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confidence: 99%

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Outcomes After Revision Anterior Shoulder Stabilization: A Systematic Review

Lau

Johnston

Gregory

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Primary shoulder stabilization is successful, but there continues to be a risk of recurrence after operative repair, particularly in the young athlete. It is important for surgeons to understand the outcomes after various revision stabilization techniques to best counsel patients and manage expectations. Purpose: To analyze recurrent instability and revision surgery rates in patients who underwent revision anterior glenohumeral stabilization procedures with either arthroscopic repair, open repair, coracoid transfer, free bone block, or capsular reconstruction. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a systematic review of level 2 to 4 evidence studies using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Clinical studies of revision anterior glenohumeral stabilization (arthroscopic repair, open repair, coracoid transfer, free bone block, or capsular reconstruction) with a minimum 2-year follow-up were analyzed. The rate of recurrent instability, rate of revision surgery, patient-reported outcomes, and range of motion were extracted and reported. Study methodological quality was evaluated using the Downs and Black quality assessment score. Results: A total of 37 studies met inclusion criteria and were available for analysis: 20 studies evaluated arthroscopic repair, 8 evaluated open repair, 5 evaluated Latarjet procedure, 3 evaluated bone block, and 2 evaluated capsular reconstruction. There was 1 study included in both arthroscopic and Latarjet procedures, for a total of 1110 revision cases. There was 1 level 2 study, and the remainder were level 3 or 4 with poor Downs and Black scores. Participants analyzed were most commonly young (weighted mean age, 26.1 years) and male (78.4%). The weighted mean clinical follow-up after revision surgery was 47.8 months. The weighted mean rate of recurrent instability was 3.8% (n = 245) after the Latarjet procedure, 13.4% (n = 260) after open repair, 16.0% (n = 531) after arthroscopic repair, 20.8% (n = 72) after bone block, and 31.0% (n = 35) after capsular reconstruction. The weighted mean rate of additional revision surgery was 0.0% after bone block, 0.02% after the Latarjet procedure, 9.0% after arthroscopic repair, 9.3% after open repair, and 22.8% after capsular reconstruction. Patient-reported outcomes and objective measures of range of motion and strength improved with all revision techniques. Conclusion: The current review identifies a deficiency in the literature pertaining to consistent meaningful outcomes and the effect of bone loss after revision shoulder stabilization. Published studies demonstrate, however, that revision shoulder stabilization using arthroscopic, open, coracoid transfer, or bone block techniques yielded satisfactory objective and patient-reported outcomes. The Latarjet procedure exhibited the lowest recurrent instability rate. This study confirms that recurrent instability remains a common problem, despite revision shoulder stabilization. The quality of research in revision shoulder stabilization remains poor, and higher quality studies are needed to establish best practices for treatment of this complex problem.

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Clinical outcomes following revision anterior shoulder stabilization: arthroscopic revision stabilization vs. latarjet

Cited by 2 publications

References 0 publications

Low grade of osteoarthritis development after Latarjet procedure with a minimum 5 years of follow-up: a systematic review and pooled analysis

Low grade of osteoarthritis development after Latarjet procedure with a minimum 5 years of follow-up: a systematic review and pooled analysis

Outcomes After Revision Anterior Shoulder Stabilization: A Systematic Review

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