Modified Latarjet Without Capsulolabral Repair in Rugby Players With Recurrent Anterior Glenohumeral Instability and Significant Glenoid Bone Loss

Ranalletta, Maximiliano; Rossi, Luciano; Bertona, Agustín; Tanoira, Ignacio; Hidalgo, Ignacio Alonso; Maignon, Gastón; Bongiovanni, Santiago

doi:10.1177/0363546517749586

Cited by 33 publications

(57 citation statements)

References 27 publications

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“…Previous authors have also reported high rates of return to sport in collision (G2) athletes, ranging between 65% and 97%, with the Latarjet procedure indicated as a primary surgery. 4,11,21,26,29 However, none of these studies included patients who underwent a revision procedure. Regarding the postoperative level of sport achieved after surgery, only 5% of our patients noticed a decrease in their sports performance.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Modified Latarjet Performed as a Primary or Revision Procedure in Competitive Athletes: A Comparative Study of 100 Patients With a Minimum 2-Year Follow-up

Rossi

Bertona

Tanoira

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:The literature lacks evidence comparing outcomes between the Latarjet procedure performed as a primary procedure versus a revision procedure in competitive athletes.Purpose:To compare return to sport, functional outcomes, and complications of the modified Latarjet performed as a primary or revision procedure in competitive athletes.Study Design:Cohort study; Level of evidence, 3.Methods:Between June 2008 and June 2015, a total of 100 competitive athletes with recurrent anterior shoulder instability underwent surgery with the congruent arc Latarjet procedure without capsulolabral repair. There were 46 patients with primary repairs and 54 with revisions. Return to sport, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sport activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed by computed tomography.Results:The mean follow-up period was 58 months (range, 24-108 months). A total of 96 patients (96%) returned to competitive sports; 91% returned to their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistically significant improvements after surgery (P < .001). The Rowe score increased from a preoperative mean of 43.8 to a postoperative mean of 96.1 (P < .01). Subjective pain during sports improved from a preoperative VAS score of 3.3 to a postoperative score of 1.2 (P < .01). The ASOSS score improved significantly from a preoperative mean of 46.3 to a postoperative mean of 88.1 (P < .001). No significant differences in shoulder ROM and functional scores were found between patients who underwent a primary versus a revision procedure. No recurrence of shoulder dislocation or subluxation was noted. The bone block healed in 91 patients (91%).Conclusion:In competitive athletes with recurrent anterior glenohumeral instability, the modified Latarjet procedure produced excellent functional outcomes, with most athletes returning to sport at the same level they had before surgery and without recurrence, regardless of whether the surgery was performed as a primary or a revision procedure.

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Section: Discussionmentioning

confidence: 99%

Comparison Between Modified Latarjet Performed as a Primary or Revision Procedure in Competitive Athletes: A Comparative Study of 100 Patients With a Minimum 2-Year Follow-up

Rossi

Bertona

Tanoira

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…The 14 studies analyzed in the systematic review included 883 patients. [2][3][4][5][6][7][8]10,11,14,[16][17][18]21 The studies were primarily level 3 (n = 4) or level 4 (n = 10) evidence; of the 14 studies, 13 had a MINORS score greater than 80%. Of the studies that reported the participants' sex, the majority were male (88%).…”

Section: Resultsmentioning

confidence: 99%

Return to Sport After Coracoid Transfer in Athletes With Anterior Shoulder Instability: A Systematic Review

2019

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Context: Recurrent shoulder instability in young athletes can lead to a spectrum of soft tissue and bony lesions that can be bothersome and/or disabling. Coracoid transfer is a treatment option for athletes with recurrent instability. Objective: To report the rate of return to sport for athletes after coracoid transfer. Data Sources: An electronic search of the literature was performed using the PubMed (MEDLINE) and Cochrane Databases (1966-2018). Study Selection: Studies were included if they evaluated return to sport after treatment with coracoid transfer at a minimum 1-year follow-up. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data were extracted by 2 authors and included study design, level of evidence, patient demographics (number, age, sex), procedure performed, duration of clinical follow-up, rate of return to sport, patient-reported outcome measures, reoperations, and complications. Results: Fourteen studies met the inclusion criteria. The rate of return to sport at any level ranged from 80% to 100% in all but 1 study (38%), and the rate of return to the previous level of play ranged from 56% to 95% in all but 1 study (16%). Patients returned to sport at an average of 3.2 to 8.1 months. The average patient-reported outcome scores ranged from 78% to 94% (Rowe), 223.6 to 534.3 (Western Ontario Shoulder Instability Index), and 75% to 90% (subjective shoulder value). The rate of postoperative dislocation ranged from 0% to 14%, and the reoperation rate ranged from 1.4% to 13%. Conclusion: There was a high early rate of return to sport in patients who underwent coracoid transfer for anterior shoulder instability, although patients did not reliably return to the same level of play. The procedure had very favorable outcomes for treatment of instability, with low rates of recurrent dislocation and reoperation.

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“…Partial lysis of the coracoid occurs frequently but only rarely leads to persistent apprehension and unsatisfactory outcomes, and no specific management is required unless too proud and/or symptomatic metalwork. 16 , 17 , 18 …”

Section: Discussionmentioning

confidence: 99%

Modified Latarjet Procedure Without Capsulolabral Repair for Failed Previous Operative Stabilizations

Ranalletta

Bertona

Tanoira

et al. 2018

Arthroscopy Techniques

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The optimal management of recurrent anterior shoulder instability with significant glenoid bone loss continues to be a challenge. The high recurrence rates seen in arthroscopic Bankart repair in the presence of significant glenoid bone loss have led many surgeons to choose bony reconstructions to manage these injuries. The Latarjet procedure acts through the combination of 3 different mechanisms: the coracoid bone graft restores and extends the glenoid articular arc, the conjoint tendon acts as a dynamic sling on the inferior subscapularis and anteroinferior capsule when the arm is abducted and externally rotated, and the effect of repairing the capsule to the stump of the coracoacromial ligament. However, in patients with multiple recurrences and previous surgeries, the anteroinferior labrum and capsule are often very deficient or practically destroyed. This Technical Note provides a detailed description of the modified Latarjet procedure without capsulolabral repair for patients with failed previous operative stabilizations.

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Modified Latarjet Without Capsulolabral Repair in Rugby Players With Recurrent Anterior Glenohumeral Instability and Significant Glenoid Bone Loss

Abstract: In rugby players with recurrent anterior shoulder instability and significant glenoid bone loss, the modified Latarjet procedure without capsulolabral repair produced excellent functional outcomes, with most athletes returning to rugby at their preinjury level of play without recurrences.

Cited by 33 publications

References 27 publications

Comparison Between Modified Latarjet Performed as a Primary or Revision Procedure in Competitive Athletes: A Comparative Study of 100 Patients With a Minimum 2-Year Follow-up

Comparison Between Modified Latarjet Performed as a Primary or Revision Procedure in Competitive Athletes: A Comparative Study of 100 Patients With a Minimum 2-Year Follow-up

Return to Sport After Coracoid Transfer in Athletes With Anterior Shoulder Instability: A Systematic Review

Modified Latarjet Procedure Without Capsulolabral Repair for Failed Previous Operative Stabilizations

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