Results and return to sports at 5 years after Latarjet for anterior instability with or without pre-operative glenoid bone loss.

INTRODUCTION The Latarjet procedure provides reliable functional outcomes and a high rate of return to sport in the treatment of anterior shoulder instability. While traditionally indicated in cases of significant glenoid bone loss (GBL) or engaging Hill-Sachs lesions, its use has progressively expanded to a broader range of clinical situations. However, few studies have specifically evaluated outcomes of the Latarjet procedure according to the degree of preoperative GBL. HYPOTHESIS We hypothesized that preoperative glenoid bone loss does not significantly influence clinical outcomes or return to sport following the open Latarjet procedure.

Method

This multicenter retrospective study included patients who underwent open Latarjet as a primary procedure before June 2017, with a minimum follow-up of 5 years. Preoperative CT or CTA was required for inclusion. Patients were divided into three groups according to preoperative GBL (<5%, 5-15%, and >15%), based on commonly used but arbitrary thresholds in the literature. Clinical outcomes were assessed using Rowe, Walch-Duplay, Simple Shoulder Value (SSV), and Shoulder Instability-Return to Sport after Injury (SIRSI) scores. Return to sport, complications, and radiographic outcomes were also analyzed.

Results

Return to sport was 80% at 1 year and 85% at final follow-up, with 48% returning to the same level. The recurrence rate was 6%, and subjective apprehension persisted in 17% of patients. The overall complication rate was 8%, including hardware-related complications, with a screw removal rate of 2%. Preoperative GBL did not significantly influence clinical outcomes or return to sport. Osteoarthritis was observed in 25% of cases (13% for GBL < 5%, 29% for GBL 5-15%, and 34% for GBL > 15%). Radiographic osteoarthritis increased with preoperative GBL (13%, 29%, and 34% respectively; p = 0.03).

Discussion

At medium-term follow-up, the Latarjet procedure provides reliable clinical outcomes, a low recurrence rate, and a high rate of return to sport, regardless of preoperative GBL. These findings support the use of the Latarjet procedure across a wide spectrum of anterior shoulder instability, although a proportion of patients continue to experience apprehension and do not return to their previous level of sport. LEVEL OF EVIDENCE IV.