Long-term prevalence and impact of glenohumeral osteoarthritis after Latarjet-Patte procedure for anterior instability

The Latarjet procedure provides satisfactory functional results, with low rates of recurrence. It is, however, sometimes claimed to induce osteoarthritis due to the positioning of the bone-block and hardware. The aims of the present study were to assess the long-term prevalence of osteoarthritis fol...

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Published in:	Orthopaedics & traumatology, surgery & research surgery & research, 2023-06, Vol.109 (4), p.103050-103050, Article 103050
Main Authors:	Lalanne, Clément, Vervoort, Thomas, Cassagnaud, Xavier, Szymanski, Christophe, Bourgault, Caroline, Pougès, Cecile, Maynou, Carlos
Format:	Article
Language:	eng
Subjects:	Adult Anterior shoulder instability Arthroscopy - methods Glenohumeral joint Humans Joint Instability - diagnostic imaging Joint Instability - epidemiology Joint Instability - etiology Latarjet Long-term Osteoarthritis Osteoarthritis - diagnostic imaging Osteoarthritis - epidemiology Osteoarthritis - etiology Prevalence Recurrence Retrospective Studies Risk factor Shoulder Dislocation - surgery Shoulder Joint - diagnostic imaging Shoulder Joint - surgery
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Summary:	The Latarjet procedure provides satisfactory functional results, with low rates of recurrence. It is, however, sometimes claimed to induce osteoarthritis due to the positioning of the bone-block and hardware. The aims of the present study were to assess the long-term prevalence of osteoarthritis following the procedure, to determine risk factors and assess clinical impact. The study hypothesis was that osteoarthritis risk can be reduced by good bone-block positioning. The secondary objective was to assess long-term recurrence of instability. Out of a cohort of 102 patients (106 shoulders) operated on between 1984 and 1998, 77 had complete radiology files for analysis in a previous study published in 2003. Forty-four of these patients were seen again for clinical and radiological assessment at a mean 22 years’ follow-up, to be compared to results previously reported at 8 years. Clinical assessment comprised range of motion and Constant and Walch-Duplay scores. X-rays were taken systematically to determine Samilson osteoarthritis stage; 31 patients also underwent CT. In the 44 patients, the rate of osteoarthritis was 34.1%. 90.9% of patients were satisfied. Mean Constant score was 83.5±14 and mean Walch-Duplay score was 71.6±23.4. Advanced age at surgery and at assessment, length of follow-up and age >30 years at first episode of instability were the main factors for onset of osteoarthritis, independently of surgery. Lateral bone-block overhang correlated with onset of osteoarthritis: 71.4%, versus 16.7% in medial or flush bone-block (p=0.0004). Humeral notch, glenoid bone defect and number of preoperative episodes of instability were unrelated to onset of osteoarthritis. Lateral bone-block overhang was the only risk factor related to surgery. The clinical impact of the osteoarthritis was significant only in advanced stages (Samilson 3 and 4). Lateral bone-block overhang was the only surgical risk factor for osteoarthritis in the long-term. Strict coracoid positioning is therefore essential, and could be facilitated by specific instrumentation and by arthroscopy. IV; retrospective study.
ISSN:	1877-0568 1877-0568