Abstract
Objectives:
The open Latarjet (OL) is a bony transfer procedure used in the treatment of anterior shoulder instability in those at greater risk of recurrence. OL has shown excellent return to play (RTP) and low recurrence in athletes, but there is limited published evidence for outcomes over long-term follow-up. The purpose of this study was to evaluate the outcomes of athletes 5-years postoperatively following the OL procedure, and to evaluate factors associated with satisfaction and shoulder function, as defined by subjective shoulder value (SSV).
Methods:
A retrospective review of athletes who underwent OL under a single surgeon with a minimum of 5-year follow-up was performed. Recurrence, Visual Analogue Scale (VAS) for pain, satisfaction, SSV, Rowe score, Shoulder Instability-Return to Sport After Injury (SI-RSI) score, whether they would undergo the same surgery again, along with rate, level and timing of RTP, were evaluated. Multilinear regression models were used to evaluate factors affecting postoperative satisfaction and SSV level.
Results:
Overall, 126 shoulder in 117 male athletes who underwent OL were included, with a mean age of 22.8 ± 5.8 years old, with mean follow-up of 71.5 ±10.3 months (range 60-84 months). At final follow-up, 92.46% were satisfied/very satisfied, and the mean SSV was 85.5 ± 14.9. Overall, the rate of RTP was 90.5%, with 79.8% returning at the same level or higher level at a mean of 7.3 ± 2.9 months. There were 9 athletes (7.1%) who experienced further dislocation, all during contact sports. In total, 9 (7.1%) athletes had a further operation, 3 (2.4%) of which were for further instability. The mean SI-RSI score was 82.3 ± 27.3 and the mean Rowe score was 84.7 ± 17.4, while the mean VAS score was 2.1 ± 1.9. Linear regression revealed that the SI-RSI score (p < 0.001), SSV (p = 0.003), and RTP (p = 0.049) were associated with satisfaction. The SI-RSI score (p = 0.023), VAS score (p < 0.001), Rowe score (p = 0.028), and RTP (p = 0.013), were all associated with SSV score.
Conclusions:
At a minimum 5-year follow-up, there was a very high rate of satisfaction, with excellent patient-reported outcomes, low rates of recurrent instability, and a high rate of RTP among athletes. This study identified that the SI-RSI score, VAS score, Rowe score and ability to RTP at the same level were associated with both satisfaction and SSV score.