Anterior Capsulolabral Repair During Arthroscopic Latarjet Reduces the Risk of Osteoarthritis Development: A Matched-Pair Study

Abstract

The effect of capsulolabral repair during the arthroscopic Latarjet procedure on the development of osteoarthritis (OA) remains unclear. To analyze the impact of capsulolabral repair during the arthroscopic Latarjet procedure on OA development and postoperative outcomes. Cohort study; Level of evidence, 3. Patients who underwent capsulolabral repair following the arthroscopic Latarjet were matched-paired with patients who did not undergo capsulolabral repair based on demographic and anatomic variables. The presence and severity of glenohumeral OA were assessed preoperatively and 2 and 5 years after surgery using a computed tomography (CT) scan. Recurrence, the Rowe score, Western Ontario Shoulder Instability Index, subjective shoulder value, and return-to-sport rate at the final follow-up were also recorded and compared between the 2 groups. Range of motion was evaluated preoperatively and at 6 weeks and 3, 6, and 12 months after surgery. A total of 86 patients, 43 in each group, with a mean age of 32.3 ± 23.2 years, were included. Preoperative OA was present in 25.6% and 16.3% in the nonrepair and repair groups, respectively ( P = .524). At the 2-year follow-up CT scan, OA progression was observed in 30.2% (13/43) of patients in the repair group and 58.1% (25/43) in the nonrepair group ( P = .009). Overall, OA progression was more severe in cases without capsular repair ( P = .008). OA progression within 5 years was significantly higher in patients without capsular repair (72.4% vs 55%, P = .035). Furthermore, patients without capsular repair showed a greater degree of OA progression than those with capsular repair ( P = .024), with 31% and 20% of patients, respectively, experiencing an increase of 2 or more OA grades. The external rotation in arm adduction was significantly restricted in patients with capsular repair at the 6-week follow-up (29 ± 19.6 vs 20.1 ± 2, P = .045) but did not differ at 3, 6, and 12 months postoperatively. Patients undergoing a capsulolabral repair at the time of arthroscopic Latarjet had a significantly lower incidence, progression, and severity of OA at both 2- and 5-year follow-up. Although early postoperative external rotation was more limited in the capsulolabral repair group, external rotation at the 12-month follow-up did not show significant differences between groups.