The Latarjet Procedure at the National Football League Scouting Combine: An Imaging and Outcome Analysis

Abstract

Objectives:The Latarjet procedure is commonly implemented in the treatment of shoulder instability in the setting of glenoid bone loss, particularly in contact athletes such as American football players; however, little is known regarding the outcomes and failures rates of this procedure in collegiate football players prior to participating in the National Football League (NFL). The purposes of this study were to 1) determine the prevalence, clinical features, and imaging findings of National Collegiate Athletic Association (NCAA) football athletes who presented to the NFL scouting Combine having undergone the Latarjet procedure and 2) to evaluate the impact of this procedure, including imaging findings on these athletes’ performance as they entered the NFL.Methods:All NFL football players at the NFL Combine from 2009 to 2016 were reviewed. Inclusion criteria were any player who had a documented Latarjet procedure in the past and participated in medical and performance testing at the NFL Combine. Medical records, imaging, games and position played, and draft position of each player who had undergone a Latarjet procedure was then analyzed. In addition, radiographic features of each players with a Latarjet were evaluated including type of fixation, hardware complications, position of the bone block, degenerative changes, and healing/union/bony resorption were all assessed. NFL performance outcomes (draft position and number of games played and started within first two years) were assessed.Results:Of the 2285 players who participated in the NFL combine between 2009 and 2016, there were 13 athletes (0.6%) who had undergone a Latarjet procedure. Six patients had a two-screw fixation of the bone block while 7 had only one screw, with two patients evidencing a broken hardware (one with one screw and one with 2 screws) and two patients with bent screws (one with one screw and one with 2 screws). Screw prominence was observed in 1 patient. Eight of the 13 patients identified underwent computed tomography (CT) scans. All had evidence of bony resorption of the bone block on CT imaging. The majority of these (5) had evidence of minimal resorption (<25%). One had a moderate amount of resorption (<50%) and two others had almost resorption of the bone block.Conclusion:Only a small percentage of players at the NFL combine (0.6%) had undergone a Latarjet procedure in the past. Nevertheless, a high number of postoperative complications were observed including broken or bent screws and prominent hardware. Optimal graft positioning was observed in the majority of the patients. However, bone resorption was found in most of them.