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

Abstract

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.

The arthroscopic treatment of anterior shoulder instability with glenoid bone loss shows similar clinical results after Latarjet procedure and iliac crest autograft transfer

“…The post-operative range of motion after bony stabilization of the glenoid has been under debate lately [25,31] patients after open Latarjet procedures [12]. Additionally, a biomechanic evaluation by Giles et al demonstrated a significant loss of high external rotation after Latarjet procedures in a cadaveric model when the conjoint tendon was loaded [17].…”

“…The post‐operative range of motion after bony stabilization of the glenoid has been under debate lately [25, 31]. A recent study by Sinha et al could demonstrate a significant loss of abduction, forward flexion, external rotation and internal rotation after the open Latarjet procedure, whereas the muscle strength was not impaired [33].…”

Arthroscopic Latarjet Procedure Using FiberTape Cerclage With a Simplified Technique for Suture Passage and Coracoid Fixation

“…Osteoarthritis on long-term follow-up in the glenohumeral joint after traditional Latarjet procedure is a concern, and prominent bone block or metal-ware are the major attributed causes. 14 Osteolysis of the superior aspect of the transferred coracoid bone after Latarjet is a common phenomenon, 16,17 and this can make the screw heads used for Latarjet procedure more prominent. Cohen et al 16 report an incidence of osteolysis of up to 57.8%, although this did not affect the long-term outcome significantly.…”

“…This capsular reattachment on to the glenoid rim [Fig: 10A] helps to exteriorize the coracoid bone (Fig 10C ) and further aids in preventing inferior wear on humeral head reported in previous long-term studies of Latarjet procedure. 14 Tips and tricks for this technique are given in Table 3, and pearls and pitfalls in Table 4. 15 The limitations and risks of this procedure are described in Table 5.…”

“…18,19 The glenoid tunnel drilling from posterior to anterior using the glenoid jig allows accurate placement of the coracoid graft with respect to the glenoid face, thus eliminating problems of coracoid graft impingement on the humeral head. 14 The FiberTape passage is made simpler in our technique by shuttling them in a straight line through the glenoid drill holes and through the coracoid holes, using the M portal to shuttle the tapes to and fro. In the technique described earlier by Hachem et al, 9 the tape has to be passed as 90 to the glenoid drill holes and this often causes abrasion at the glenoid hole edges and difficulty in passage.…”