Return to Play After the Latarjet Procedure for Anterior Shoulder Instability: A Systematic Review

Abstract

Background: Traumatic anterior shoulder instability is a common clinical problem among athletic populations. The Latarjet procedure is a widely used treatment option to address shoulder instability in high-demand athletes at high risk of recurrence. However, rates and timing of full return to sports have not been systematically analyzed. Purpose: To systematically review the evidence in the literature to ascertain the rate and timing of return to play and the availability of specific criteria for safe return to play after the Latarjet procedure. Study Design: Systematic review. Methods: A systematic literature search was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using the EMBASE, MEDLINE, and Cochrane Library databases. Eligible for inclusion were clinical studies reporting on return to play after the Latarjet procedure. Statistical analysis was performed by use of SPSS. Results: Our review found 36 studies including 2134 cases meeting our inclusion criteria. The majority of patients were male (86.9%), with a mean age of 25.4 years (range, 15-59 years) and a mean follow-up of 83.5 months. The overall rate of return to play was 88.8%, with 72.6% returning to the same level of play. Among collision athletes, the overall rate of return to play was 88.2%, with 69.5% returning to the same level of play. In overhead athletes, the overall rate of return to play was 90.3%, with 80.6% returning to the same level of play. The mean time to return to play was 5.8 months (range, 3.2-8 months). Specific return to play criteria were reported in the majority of the studies (69.4%); time to return to sport was the most commonly reported item (66.7%). Conclusion: The overall rate of return to play was reportedly high after the Latarjet procedure. However, almost a fifth of athletes returning to sports were not able to return at the same level. Further development of validated criteria for safe return to sports could potentially improve clinical outcomes and reduce recurrence rates.

Are Patients Who Undergo the Latarjet Procedure Ready to Return to Play at 6 Months? A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group Cohort Study

“…A large percentage of athletes, 55%, failed to meet the defined RTP criteria at 6 months. However, recent meta-analyses noted that the average time for successful RTP after Latarjet is 5.3 to 5.8 months, 23,24 and some report a 3-month RTP time frame. Data on actual RTP for our cohort of athletes were not available, but the discrepancy between these numbers suggests that RTP criteria should be reexamined.…”

Return to Play after Arthroscopic Bankart Repair Combined with Open Subpectoral Biceps Tenodesis

“…Especially in high-demand populations, such as the collision or overhead athletes, where up to 30% of patients are expected to not return to their sport at the same level, regardless of the surgical treatment for anterior shoulder instability despite their overall long-term success. 6 , 25 , 26 , 27 , 28 Although the causes for the relatively high rate of patients not being able to return to the same level of sports in the current study are likely to be multifactorial, it might be a reflection of the more extensive capsuloligamentous and LHBT injury than a labrum lesion alone. 29 …”

Modified Arthroscopic Latarjet Procedure: Suture-button Fixation will not Cause Obvious Increasement of Superior Instability at 5-Year Follow-up

“…Anterior subluxation and dislocation account for 52.1% of all shoulder instability injuries, and approximately 30% of which requires surgical treatment [1]. At present, the arthroscopic Latarjet procedure has gradually become popular for the treatment of shoulder dislocation with evident glenoid defect, and many reports have con rmed that Latarjet procedure has excellent clinical results [2,3,4].…”