Outcomes of Latarjet versus Distal Tibia Allograft for Anterior Shoulder Instability Repair: A Prospective Matched Cohort Analysis

Abstract

The purpose of this study was to determine the clinical outcomes for patients undergoing distal tibia allograft (DTA) compared to a matched cohort of patients undergoing Latarjet. Consecutive patients with a minimum 15% anterior glenoid bone loss who underwent shoulder stabilization with either DTA or Latarjet with a minimum follow-up of 2 years were reviewed. Patients undergoing DTA were matched by age, BMI, and number of previous ipsilateral shoulder surgeries to patients undergoing Latarjet in a 1-to-1 format. Patients were evaluated preoperatively and at a minimum 2 years post-operatively with ASES, SANE, and WOSI outcomes assessments. Statistical analysis was performed with student T-tests, with P<0.05 considered significant. A total of 60 patients (30 Latarjet, 30 DTA) with an average age of 26.5±7.8 years were analyzed at an average 46±17 months (range, 24-87) following surgery. Twenty-two patients (73%) in each group underwent prior ipsilateral shoulder surgery (range, 1 to 3 surgeries). There were no statistical differences in age, BMI, or number of prior surgeries between the groups. There were no differences between the groups in regards to recurrent instability events, subluxation, or apprehension on final examination (P>0.8 for all). Patients in both groups experienced significant improvements in all outcomes scores following surgery (P>0.05 for all). When comparing final outcomes of Latarjet versus DTA, no significant differences were found in postoperative ASES, WOSI or SANE scores between the groups (P>0.05 for all). There was 1 reoperation in each group. There were no cases of neurovascular injuries or other complications in either cohort. At an average follow-up of nearly 4 years, fresh DTA reconstruction for recurrent anterior shoulder instability results in a clinically stable joint with similar clinical outcomes and recurrence rates compared to Latarjet.