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Clinical outcomes, return to sport, and complications after isolated primary Latarjet versus Latarjet as a revision procedure: A systematic review and meta-analysis - 26/04/24

Doi : 10.1016/j.otsr.2023.103810 
Garrett R. Jackson a, , Trevor Tuthill a, Shaan Asif a, Daniel DeWald a, Morgan Wessels a, Johnathon R. McCormick a, Enzo S. Mameri a, c, d, Derrick M. Knapik e, Filippo Familiari f, Mario Hevesi b, Anjay K. Batra a, Jorge Chahla a, Nikhil N. Verma a
a Department of Orthopaedic Surgery, Rush University Medical Center, 1611W Harrison St., 60612 Chicago, IL, USA 
b Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, 55905 Rochester, MN, USA 
c Instituto Brasil de Tecnologia da Saúde, 407 Visconde de Piraja St., 22410 Rio de Janeiro, RJ, Brazil 
d Department of Orthopedics and Traumatology, Federal University of São Paulo (EPM-UNIFESP), 740 Botucatu St., 04023 São Paulo, SP, Brazil 
e Department of Orthopaedic Surgery, Washington University and Barnes-Jewish Orthopedic Center, 14532 South Outer Forty Drive, 63017 Chesterfield, MO, USA 
f Department of Orthopaedic and Trauma Surgery, Magna Graecia University, V.le Europa (loc. Germaneto), 88100 Catanzaro, Italy 

Corresponding author. Rush University Medical Center, 1611W Harrison St., 60612 Chicago, IL, USA.Rush University Medical Center1611W Harrison St.Chicago, IL60612USA

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Abstract

Background

The purpose of this review was to compare clinical outcomes, return to sport (RTS), and complications in comparative studies examining patients undergoing primary Latarjet procedure versus Latarjet in the revision setting following soft tissue stabilization.

Methods

A literature search was conducted using PubMed and Scopus databases using Preferred Reporting Items for Systematic Meta-Analyses guidelines. Inclusion criteria consisted of level I to III human clinical studies reporting clinical outcomes (Visual Analogue Pain Scale [VAS]), RTS metrics, and complications in patients following primary versus revision Latarjet procedures. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.

Results

A total of seven studies, consisting of 1170 patients (n=1179 shoulders) with a mean age of 26.4 years, consisting of 91.9% males (n=1083/1179 shoulders), were identified. Mean final follow-up was 46.4 (mean range, 7.3–72.2) months. A total of 748 primary and 431 revision Latarjet procedures were analyzed. Complications were reported in 9.6% (range, 0%–24.2%) of patients undergoing primary and 20.2% (range, 0%–40.7%) in patients undergoing revision procedures (p=0.22). There was no significant difference in the RTS rate between patients undergoing primary (87.3%; range, 83.8%–92.1%) versus Latarjet as a revision procedure (78.9%; range, 60%–100%) (p=0.08). Moreover, no significant difference in postoperative VAS was observed in patients undergoing primary versus Latarjet as a revision procedure (p=0.21). Recurrent shoulder subluxation was significantly greater in patients undergoing revision (12.0%; n=31/259 shoulders; range, 0%–20.7%) compared to primary procedures (3.3%; n=27/511 shoulders; range, 0%–9%) (p<0.001).

Discussion

Patients undergoing primary and revision Latarjet demonstrated overall similar rates of complications and return to sport. Of clinical importance, Latarjet as a revision procedure possessed a risk of recurrent subluxation 3.6 times higher than primary Latarjet. While effective, patients should be counseled regarding the differing prognosis between Latarjet as a primary or revision procedure.

Level of evidence

III; Systematic review and meta-analysis.

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Keywords : Latarjet, Shoulder instability, Shoulder dislocation, Coracoid transfer


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© 2023  The Author(s). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 110 - N° 3

Articolo 103810- maggio 2024 Ritorno al numero
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