According to a new study, revision Latarjet procedures after Bankart repair present higher rates of recurrent instability than primary Latarjet procedures.
Latarjet as a Secondary Procedure Linked to More Instability
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#shoulderinstabilitySecondary#bankartrepair#laterjetprocedure
The study, “Latarjet After Failed Arthroscopic Bankart Repair Results In Twice the Rate Of Recurrent Instability Compared With Primary Latarjet,” was published online in the November, 2021 issue of the journal Arthroscopy.
The study research team enrolled patients from the Walter Reed Military Health System who had undergone open Latarjet between January 1, 2010, and December 31, 2018.
All the patients had been diagnosed with recurrent anterior shoulder instability and had a minimum follow-up of two years. Each patient was categorized as having a primary Latarjet or a salvage Latarjet procedure.
Studies have shown that the Latarjet procedure is successful as a primary procedure to restore shoulder joint stability, however, its role as a revision procedure is still being investigated.
The research team collected data from 234 Latarjet procedures which were performed on 234 patients. Ninety-nine of the procedures were primary Latarjet while 135 were salvage procedures.
The overall recurrent instability rate was 15.8%, the overall reoperation rate 16.7% and the overall complication rate 14.2% over a mean 5.0 years of follow-up.
The researchers found that the salvage Latarjet group had more recurrent instability than the primary Latarjet group (20.7% vs. 9.1%; p = .0158). There were no significant differences in reoperation or complication rates, however.
“The rate of recurrent instability following the Latarjet procedure in an active, high-risk population is 15.8%. Primary Latarjet was found to have lower rates of recurrence compared with salvage Latarjet procedures (9.1% vs. 20.7%),” the authors wrote.
Study authors included Daniel L. Rodkey, M.D., Donald F. Colantoni, M.D., Lance E. LeClare, M.D., Kelly G. Kilcoyne, M.D., and Jonathan F. Dickens, M.D. of the Walter Reed National Military Medical Center in Bethesda, Maryland.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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