1. Outcomes of Arthroscopic Latarjet as a Revision Surgery After Failed Arthroscopic Bankart Repair.
- Author
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Calvo, Emilio, Dzidzishvili, Lika, Valencia, María, and Calvo, Claudio
- Subjects
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SHOULDER joint surgery , *SPORTS re-entry , *RANGE of motion of joints , *SHOULDER injuries , *JOINT instability , *ARTHROSCOPY , *RETROSPECTIVE studies , *SURGICAL complications , *SPORTS injuries , *FISHER exact test , *MANN Whitney U Test , *DISEASE relapse , *TREATMENT effectiveness , *COMPARATIVE studies , *REOPERATION , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *CHI-squared test , *SHOULDER dislocations , *DATA analysis , *LONGITUDINAL method - Abstract
Background: The role of arthroscopic Latarjet as a revision surgery after failed arthroscopic Bankart repair has yet to be established. Purpose: To compare clinical outcomes, recurrences, and complication rates of arthroscopic Latarjet as a revision procedure after failed arthroscopic Bankart repair versus arthroscopic Latarjet as a primary procedure. Design: Cohort study; Level of evidence, 3. Methods: This is a retrospective study of prospectively collected data of patients who were diagnosed with anterior shoulder instability and underwent arthroscopic Latarjet stabilization between 2009 and 2018. Patients were separated into 2 groups depending on whether Latarjet was performed after a previous instability surgery (revision) or as a primary surgery (primary). Rowe score, Western Ontario Shoulder Instability Index (WOSI), Constant-Murley Shoulder Outcome (CMSO) score, and Single Assessment Numeric Evaluation (SANE) were assessed pre- and postoperatively with a minimum 24 months of follow-up. In addition, pre- and postoperative levels of sports activity, dislocations, subluxations, and complications were assessed. Results: A total of 97 patients (n = 62 revision; n = 35 primary), with a mean age of 31.0 ± 8.8 and 29.4 ± 7.6 years old in the revision and primary Latajet group, respectively, met the inclusion criteria. The mean follow-up in the revision group was 32 months (24-53) and 35.5 months (27.7-42.2) in the primary Latarjet group. No significant differences between groups were observed in Rowe score (revision = 91.4, primary = 94.1; P =.223), CMSO score (revision = 90.7, primary = 94; P =.105), and SANE (revision = 85.8, primary = 87.3; P =.683) postoperatively. However, the postoperative difference in the WOSI score between the revision and primary Latarjet groups was nearly significant (510 ± 334 vs 403 ± 343, respectively; P =.05). Four (6.4%) postoperative dislocations were reported in the revision and 1 (2.8%) in the primary Latarjet group (P =.14). Patients in the revision group had a lower return to the previous level of sports participation (P =.008) and decreased external rotation with the arm by the side compared with the primary Latarjet group (P =.000). Conclusion: Arthroscopic Latarjet as a revision surgery is a reasonable surgical option in failed Bankart repair cases. The decision to perform arthroscopic Latarjet stabilization as a revision surgery should not be influenced by the potential risk of future complications as it provides comparable clinical outcomes to the primary Latarjet procedure with a low postoperative recurrence rate. However, a decreased level of postoperative sports participation and external rotation with the arm by the side can be expected. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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