Latarjet as a primary and revision procedure for anterior shoulder instability - A comparative study of survivorship, complications and functional outcomes in the medium to long-term.

Abstract

This retrospective study aims to compare the outcome of the Latarjet procedure when used as a primary or revision procedure for recurrent anterior gleno-humeral instability. One hundred and ninety-seven patients underwent 205 open Latarjet procedures during the period 2006-2015 (mean follow-up 5.6 years). Sixty shoulders had failure of a previous stabilisation requiring revision to the Latarjet procedure. Outcomes were measured using the Western Ontario Shoulder Instability Index and Quick Disabilities of the Arm, Shoulder and Hand score. Survival analyses were performed using Kaplan-Meier curves, and multiple linear regression modelling was utilised to identify predictors of functional outcome (p < 0.05). Two shoulders had recurrent dislocations in the cohort of 205 (1.0%). Six shoulders underwent further surgery for non-instability complications (2.9%). There were no significant differences in the clinical or functional outcome between patients undergoing a primary Latarjet procedure and those who required revision of a failed soft-tissue stabilisation. Ninety-two per cent of patients were satisfied with their shoulder following surgery. Patient-reported instability and satisfaction was significantly associated with poorer functional scores. The Latarjet procedure successfully prevents recurrent anterior instability and is associated with high levels of satisfaction. Patient-reported outcome measures suggest no difference between primary and revision procedures.