Shoulder Latarjet Surgery Shows Wide Variation in Reported Indications, Techniques, Perioperative Treatment, and Definition of Outcomes, Complications, and Failure: A Systematic Review

Arner, Justin W.; Shields, Tanner; Tanghe, Kira K.; Abdelaziz, Abed; Lee, Simon; Peebles, Liam A.; Provencher, Matthew T.

doi:10.1016/j.arthro.2021.09.020

Cited by 21 publications

(14 citation statements)

References 16 publications

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“…36,42 Notably, shoulder functional scores effectively improved after FBB-DAS. Postoperative functional scores in this cohort were comparable with those for the Latarjet procedure reported in the literature, 3 such as the VAS for pain score (1.3 vs 0.2-2.8, respectively), ASES score (95.1 vs 75.0-96.1, respectively), Rowe score (95.5 vs 78.0-97.5, respectively), and OSIS (14.8 vs 12.5-19.9, respectively). Furthermore, engaging in daily activities was not enough for high-demand patients, as returning to sports was the most important consideration for seeking surgical treatment.…”

Section: Discussionsupporting

confidence: 81%

Clinical and Radiological Outcomes in Patients With Anterior Shoulder Instability and Glenoid Bone Loss after Arthroscopic Free Bone Block Combined With Dynamic Anterior Stabilization

Fang

et al. 2022

Am J Sports Med

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Background: As an alternative to the Latarjet procedure, the arthroscopic free bone block (FBB) procedure combined with dynamic anterior stabilization (DAS) has been recently proposed to provide both glenoid augmentation and a tendon sling effect for treating anterior shoulder instability (ASI) with glenoid bone loss. Purpose: To evaluate the clinical and radiological outcomes of FBB-DAS for ASI with glenoid bone loss. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent arthroscopic FBB-DAS for ASI with >15% glenoid bone loss between February 2017 and March 2020 were screened and enrolled in this study. Clinical outcome measures were assessed preoperatively and at a minimum 2-year follow-up, including recurrence, complications, shoulder functional scores, range of motion, and return to sports. Postoperative computed tomography and magnetic resonance imaging were also performed. Results: Of a total of 65 patients with a mean follow-up of 46.1 ± 13.1 months, no patients experienced a recurrent dislocation or subluxation postoperatively, while 2 had a positive anterior apprehension test (3.1%). Additionally, 2 patients (3.1%) experienced complications of hematoma and shoulder stiffness, respectively. The mean visual analog scale score, American Shoulder and Elbow Surgeons score, Rowe score, and Oxford Shoulder Instability Score all improved significantly from 3.2 ± 2.4, 75.0 ± 18.9, 43.6 ± 27.3, and 33.8 ± 9.0 preoperatively to 1.3 ± 0.8, 95.1 ± 8.0, 95.5 ± 7.8, and 14.8 ± 3.5 at final follow-up, respectively (all P < .001). No difference was detected in range of motion except for 8.1° and 7.5° external rotation limitations in adduction and abduction, respectively. There were 62 patients (95.4%) who returned to sports, and 54 patients (83.1%) returned to the preinjury level. The transferred biceps tendon was intact in all 59 patients who completed radiological examination at the latest follow-up. Good bone healing was achieved in 98.3% of patients, and the glenoid bone defect decreased from 18.1% to 4.9%. Osseous and labral glenoids were significantly enlarged in width and depth on the latest magnetic resonance imaging (all P < .001). Conclusion: Arthroscopic FBB-DAS provided satisfactory clinical and radiological outcomes for ASI with glenoid bone loss. Despite slight external rotation restrictions, it achieved low recurrence and complication rates, excellent shoulder functional scores, a high return-to-sports rate, and favorable graft healing and remodeling.

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Section: Discussionsupporting

confidence: 81%

Clinical and Radiological Outcomes in Patients With Anterior Shoulder Instability and Glenoid Bone Loss after Arthroscopic Free Bone Block Combined With Dynamic Anterior Stabilization

Fang

et al. 2022

Am J Sports Med

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“…While multiple studies have evaluated the effectiveness of the Latarjet procedure in terms of achieving statistically significant changes postoperatively, 1,19,25 little is known about what patients view as meaningful clinical outcomes. The minimal clinically important difference (MCID) represents the smallest change in an outcome score that patients perceive as a clinical improvement.…”

mentioning

confidence: 99%

“…28 While the Latarjet is generally reserved for highrisk patients with substantial glenoid bone loss 3 or revision cases with failed soft tissue procedures 36 given its relatively high complication rate, 9,37 some surgeons have turned to more aggressively consider this procedure in contact or collision athletes because of the generally good patient-reported outcomes (PROs) and low rates of recurrent instability. 26,29,30 While multiple studies have evaluated the effectiveness of the Latarjet procedure in terms of achieving statistically significant changes postoperatively, 1,19,25 little is known about what patients view as meaningful clinical outcomes. The minimal clinically important difference (MCID) represents the smallest change in an outcome score that patients perceive as a clinical improvement.…”

mentioning

confidence: 99%

Defining Minimal Clinically Important Difference and Patient Acceptable Symptom State After the Latarjet Procedure

et al. 2022

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Background: The Latarjet procedure is one of the most well-established treatment options for anterior shoulder instability. However, meaningful clinical outcomes after this surgery have not been defined. Purpose: This study aimed to establish the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) for commonly used outcome measures in patients undergoing the Latarjet procedure and determine correlations between preoperative patient characteristics and achievement of MCID or PASS. Study Design: Case series; Level of evidence, 4. Methods: A multicenter retrospective review at 4 institutions was performed to identify patients undergoing primary open Latarjet procedure with minimum 2-year follow-up. Data collected included patient characteristics (age, sex, sports participation), radiological parameters (glenoid bone loss, off-track Hill-Sachs lesion), and 4 patient-reported outcome measures (collected preoperatively and 2 years postoperatively): the American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation (SANE), the visual analog scale (VAS) for pain, and the Western Ontario Shoulder Instability Index (WOSI). The MCID and PASS for each outcome measure were calculated, and Pearson and Spearman coefficient analyses were used to identify correlations between MCID or PASS and preoperative variables (age, sex, sports participation, glenoid bone loss, off-track Hill-Sachs lesion). Results: A total of 156 patients were included in the study. The MCID values for ASES, SANE, VAS pain, and WOSI were calculated to be 9.6, 12.4, 1.7, and 254.9, respectively. The PASS values for ASES, SANE, VAS pain, and WOSI were 86.0, 82.5, 2.5, and 571.0, respectively. The rates of patients achieving MCID were 61.1% for VAS pain, 71.6% for ASES, 74.1% for SANE, and 84.2% for WOSI. The rates of achieving PASS ranged from 78.4% for WOSI to 84.0% for VAS pain. There was no correlation between any of the studied preoperative variables and the likelihood of achieving MCID or PASS. Conclusion: This study defined MCID and PASS values for 4 commonly used outcome measures in patients undergoing the Latarjet procedure. These findings are essential for incorporating patient perspectives into the clinical effectiveness of the Latarjet procedure and provide valuable parameters for the design and interpretation of future clinical trials.

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“…Indications and rationale for primary osseous reconstruction continue to vary according to the presence of off-track lesions, critical glenoid bone loss, and failed prior surgical procedures as well as on the basis of regional preferences, as shown by a systematic review of 72 open coracoid transfer studies 24 . The surgical technique widely differed as well with respect to subscapularis and capsular management and the number of screws used.…”

Section: Shouldermentioning

confidence: 99%

“…The surgical technique widely differed as well with respect to subscapularis and capsular management and the number of screws used. Furthermore, the comparison of outcomes was inconclusive because of variability in how recurrence was measured and limited reporting of subjective stability, apprehension, or subluxation 24 .…”

Section: Glenohumeral Instabilitymentioning

confidence: 99%

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McKeithan

Lameire

Tagliero

et al. 2023

Journal of Bone and Joint Surgery

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Shoulder Latarjet Surgery Shows Wide Variation in Reported Indications, Techniques, Perioperative Treatment, and Definition of Outcomes, Complications, and Failure: A Systematic Review

Cited by 21 publications

References 16 publications

Clinical and Radiological Outcomes in Patients With Anterior Shoulder Instability and Glenoid Bone Loss after Arthroscopic Free Bone Block Combined With Dynamic Anterior Stabilization

Clinical and Radiological Outcomes in Patients With Anterior Shoulder Instability and Glenoid Bone Loss after Arthroscopic Free Bone Block Combined With Dynamic Anterior Stabilization

Defining Minimal Clinically Important Difference and Patient Acceptable Symptom State After the Latarjet Procedure

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