Primary and Revision Latarjet Procedures Offer Similar Outcomes for Contact Athletes

Research presented at the American Orthopaedic Society for Sports Medicine Annual Meeting indicates that contact athletes undergoing revision Latarjet surgery experience functional outcomes, return-to-sport rates, and stability profiles comparable to those who undergo primary Latarjet procedures. The study, which followed 138 athletes, challenges the clinical assumption that revision surgery inherently places athletes at a disadvantage regarding shoulder stability and performance.

Comparative Outcomes in Shoulder Instability

The study, conducted by the Multicenter Orthopaedic Outcomes Network (MOON) shoulder instability group, evaluated 138 contact sport athletes between December 2012 and August 2023. The cohort consisted of 61 patients who underwent primary Latarjet surgery and 77 who underwent revision Latarjet. According to Julie Bishop, MD, chief of the division of shoulder surgery at The Ohio State University, the data demonstrates that the Latarjet procedure remains an effective option for shoulder stabilization even after previous failed soft tissue surgeries.

At the two-year follow-up mark, researchers observed no statistically significant differences in glenoid bone loss between the two groups. Both cohorts achieved significant and similar improvements in functional outcomes. The revision group reported rates of recurrent subluxation (29.9% vs. 21.3%) and dislocation (3.9% vs. 0%) that were statistically similar to those of the primary group. Reoperation rates also remained comparable, at 2.6% for revision patients versus 4.9% for primary patients.

Return to Sport and Performance Metrics

A primary concern for contact athletes is the ability to return to competitive play following a second stabilization procedure. The study found that return-to-sport rates were statistically similar, with 64.9% of revision patients and 70.5% of primary patients successfully returning to their respective sports. Furthermore, the ability to perform at pre-injury levels or better was comparable between the groups, at 75.5% for the revision cohort and 72.1% for the primary cohort.

While the findings offer a positive outlook for athletes facing a second surgery, clinicians emphasize the physical and temporal costs involved. Dr. Bishop noted that while the Latarjet procedure can provide a stable shoulder in a revision setting, patients and surgeons must account for the reality of the recovery process and the loss of a competitive season.

Clinical Considerations for Revision Surgery

The study cohort showed no significant differences in demographic factors such as age, gender, dominant arm, or the duration of symptoms. However, a minor disparity was noted in body mass index (BMI), with the primary Latarjet group averaging 26 kg/m² compared to 24.7 kg/m² in the revision group. These findings suggest that for the majority of contact athletes, a failed initial stabilization does not preclude a successful return to sport through a revision Latarjet procedure.

The research underscores the effectiveness of the Latarjet procedure as a technique for recurrent instability. By providing a stable glenoid architecture, the surgery allows a significant portion of athletes to resume high-impact activities. These results provide an evidence-based framework for surgeons counseling athletes who are managing the risks of recurrent shoulder instability.