scholarly journals LATARJET PROCEDURE ON ANTERIOR SHOULDER INSTABILITY IN PROFESSIONAL SOCCER PLAYERS

2020 ◽  
Vol 28 (2) ◽  
pp. 84-87
Author(s):  
GUILHERME AUGUSTO STIRMA ◽  
EWERTON BORGES DE SOUZA LIMA ◽  
DEGINALDO HOLANDA CHAVES ◽  
PAULO SANTORO BELANGERO ◽  
CARLOS VICENTE ANDREOLI ◽  
...  

ABSTRACT Anterior glenohumeral instability is a frequent cause of professional soccer players’ removal, reduced performance, and prolonged recovery. Players are subjected to intense physical contact and high performance, thus demanding lower rates of recurrence after surgical correction so they can return to sport quickly. Objective: To assess professional soccer players treated by the Lartajet technique considering the rate and time of return to sports activities, complications or failures. Methods: Analysis held between 2010 and 2018 of professional soccer players diagnosed with anterior shoulder instability operated by the open procedure of Lartajet in our service. Results: The mean return to professional sports was 93.5 days. The mean time of surgery in relation to the first dislocation was 12.4 months. Each athlete had 4.3 shoulder dislocations until the procedure was performed. The rate of recurrence was zero and subluxation was not observed. Conclusion: The Latarjet procedure allowed all professional athletes to return to competitive activities quickly, without dislocations and subluxation, negative seizure and without complications during follow-up. Level of evidence IV, Case series.

2018 ◽  
Vol 26 (5) ◽  
pp. 328-331 ◽  
Author(s):  
Alexandre Tadeu do Nascimento ◽  
Gustavo Kogake Claudio ◽  
Pedro Bellei Rocha ◽  
Juan Pablo Zumárraga ◽  
Olavo Pires de Camargo

ABSTRACT Objective: The cause of anterior shoulder instability is not fully understood and surgical management remains controversial. The objective of this study was to evaluate the results of patients undergoing arthroscopic Latarjet procedure with endobuttons. Methods: A retrospective study of 26 patients undergoing arthroscopic Latarjet procedure with endobuttons to treat anterior shoulder instability. Patients with previous glenohumeral instability, failure of Bankart procedure or Instability Severity Index Score (ISIS) greater than or equal to 6, were included. Patients were assessed by: DASH, UCLA, Rowe, Visual Analog Scale (VAS) of pain and Short-Form 36 (SF36) scores. Correct position and consolidation of the graft were evaluated. Results: Mean age was 31.5 years (16 to 46). Preoperative duration of symptoms was 1.7 years (1 month to 10 years). Mean follow-up was 14.3 (6 to 24) months. Mean postoperative scores were: 10 points in DASH; 1.6 in VAS, where 23 (88%) patients experienced mild pain and 3 (12%) moderate pain; 89 in Rowe; 32 in UCLA and 78 in SF-36. Positioning of the graft was correct in 25 (96%) cases, and was consolidated in 23 (88%). We had two cases of graft fracture (7%) and postoperative migration (7%). Conclusion: Surgical treatment using arthroscopic Latarjet with endobuttons is safe and effective, producing good functional outcomes in patients. Level of Evidence IV, Case Series.


2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094136
Author(s):  
Eran Maman ◽  
Oleg Dolkart ◽  
Rafael Krespi ◽  
Assaf Kadar ◽  
Gabriel Mozes ◽  
...  

Background: Arthroscopic Bankart repair (ABR) and the Latarjet procedure are surgical techniques commonly used to treat anterior shoulder instability. There is no consensus among shoulder surgeons regarding the indications for choosing one over the other. Purpose: To compare the results of the Latarjet procedure with those of ABR for the treatment of anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Data on all patients who were treated surgically for recurrent anterior shoulder instability between 2006 and 2011 were retrospectively collected at 4 medical centers. The minimum follow-up was 5 years. Data were retrieved from medical charts, and patients were interviewed to assess their level of satisfaction (range, 0-100), functional outcomes (using the American Shoulder and Elbow Surgeons shoulder score; the Subjective Shoulder Value; and the Disabilities of the Arm, Shoulder and Hand score), and quality of life (using the 12-Item Short Form Health Survey [SF-12]). Information on return to sports activities and postoperative level of activity compared with that of the preinjury state, complications, reoperations, and recurrent instability were recorded and evaluated. Results: A total of 242 patients were included. The Latarjet procedure was performed in 27 shoulders, and ABR was performed in 215 shoulders. Patients in the ABR group had significantly higher rates of redislocation (18.5%; P = .05) and subluxation (21.4%; P = .43) but a lower rate of self-reported apprehension (43.0%; P = .05) compared with patients in the Latarjet group (3.7%, 14.8%, and 63.0%, respectively). There were 5 patients in the ABR group who underwent reoperation with the Latarjet procedure because of recurrent instability. The functional scores in the Latarjet group were better than those in the ABR group. The SF-12 physical score was significantly better in the Latarjet group than in the ABR group (98.1 vs 93.9, respectively; P = .01). Patient satisfaction and subjective scores were similar in both groups. Conclusion: These results support recently published data on the Latarjet procedure that showed its superiority over ABR in midterm stability (dislocations or subluxations). The contribution of self-reported apprehension to the broad definition of stability is not clear, and apprehension rates were not correlated with satisfaction scores or the recurrence of dislocation or subluxation.


2020 ◽  
pp. 175857322092892
Author(s):  
Ignacio Pasqualini ◽  
Luciano A Rossi ◽  
Ignacio Tanoira ◽  
Maximiliano Ranalletta

Background There is a shortage of relevant reports about the results obtained after shoulder stabilization in soccer players. Therefore, this retrospective study aims to report return to sports, functional outcomes, and recurrences after arthroscopic Bankart repair in soccer players. Methods A total of 156 soccer players were treated for anterior shoulder instability at a single institution between 2008 and 2017. The Rowe score and Athletic Shoulder Outcome Scoring System were used to assess functional outcomes. Return to sport and recurrence rates were also evaluated. Results The Rowe and Athletic Shoulder Outcome Scoring System scores showed statistical improvement after surgery (P < .001). Overall, 148 soccer players (94.8%) returned to sports, and 122 (78.2%) returned to the same level. The mean time to return to sport was 4.8 months. The recurrence rate was 5.2%. Discussion Soccer players who underwent an arthroscopic isolated Bankart repair for anterior glenohumeral instability have shown remarkable outcomes, with most of the patients returning to sports, and at the same level they had before surgery with a low rate of recurrence.


2019 ◽  
Vol 7 (5_suppl3) ◽  
pp. 2325967119S0020
Author(s):  
Jean-David Werthel ◽  
Vincent Sabatier ◽  
Lior Amsallem ◽  
Marie Vigan ◽  
Alexandre Hardy

Objectives The two most common surgical interventions for recurrent anterior shoulder instability include arthroscopic Bankart repair and the Latarjet procedure. However, indications for each procedure remain debated between surgeons with 90% of surgeons (except French surgeons) preferring soft tissue Bankart repair initially. It remains unclear whether the results of a Latarjet procedure performed after a failed arthroscopic Bankart repair differ from those performed for primary cases. The purpose of our study was to compare the postoperative outcomes of patients who had undergone a Latarjet as a primary surgery versus those who had had a Latarjet as revision surgery for a failed arthroscopic Bankart repair Methods Patients who had undergone open or arthroscopic Latarjet procedure between 2003 and 2015 in 5 fellowship-trained surgical practices were included. Charts were retrospectively reviewed to identify patients who had undergone a primary Latarjet or those who had had a Bankart repair prior to the Latarjet. Age, ISIS score, BMI, sports activity, hyperlaxity and delay before surgery were retrospectively collected. Outcome measures were prospectively collected, including range of motion, SSV, Walch-Duplay, scores, recurrence of instability, apprehension or new surgery. Results A total of 311 patients were included. 28% of the patients were lost to follow-up and the mean follow-up was 3.4 years +/-0.8. There were 21 patients who had had a Bankart repair prior to the Latarjet procedure. Both populations were comparable regarding preoperative data. The postoperative instability rate was 3% in the overall population; 4.8% in the “primary Latarjet” group and 2.3% in the ”Latarjet for failed Bankart” group. This difference was not significant (p=0.50). However, the mean Walch-Duplay score was significantly lower and the pain scores significantly higher in patients who had had a prior Bankart repair: 51.9 +/- 25 versus 72.1 +/- 25.2 and 2.5/10 versus 1.2/10 respectively. The Simple Shoulder Test was comparable in both groups. Conclusion The study confirms that the Latarjet is an effective procedure to treat primary chronic anterior instability and also to stabilize a shoulder after a failed Bankart repair. However, the thought that a Bankart repair does not “burn any bridges” appears to be incorrect relative to postoperative pain and functional scores in the setting of future Latarjet procedure.


2009 ◽  
Vol 37 (9) ◽  
pp. 1792-1797 ◽  
Author(s):  
Pei-Wei Weng ◽  
Hsain-Chung Shen ◽  
Hsieh-Hsing Lee ◽  
Shing-Sheng Wu ◽  
Chian-Her Lee

Background Severe glenoid bone loss in recurrent anterior glenohumeral instability is rare and difficult to treat. Purpose The authors present a surgical technique using allogeneic bone grafting for open anatomic glenoid reconstruction in addition to the capsular shift procedure. Study Design Case series; Level of evidence, 4. Methods Nine consecutive patients with a history of recurrent anterior shoulder instability underwent reconstruction of large bony glenoid erosion with a femoral head allograft combined with an anteroinferior capsular shift procedure. Preoperative computed tomographic and arthroscopic evaluation was performed to confirm a ≥120° osseous defect of the anteroinferior quadrant of the glenoid cavity, which had an “inverted-pear” appearance. Patients were followed for at least 4.5 years (range, 4.5-14). Serial postoperative radiographs were evaluated. Functional outcomes were assessed using Rowe scores. Results All grafts showed bony union within 6 months after surgery. The mean Rowe score improved to 84 from a preoperative score of 24. The mean loss of external rotation was 7° compared with the normal shoulder. One subluxation and 1 dislocation occurred after grand mal seizures during follow-up. These 2 patients regained shoulder stability after closed reduction. The remaining patients did not report recurrent instability. All patients resumed daily activities without restricted motion. Conclusion This technique for open reconstruction is viable for the treatment of recurrent anterior glenohumeral instability with large bony glenoid erosion.


2017 ◽  
Vol 46 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Johannes E. Plath ◽  
Daniel J.H. Henderson ◽  
Julien Coquay ◽  
Klaus Dück ◽  
David Haeni ◽  
...  

Background: The glenoid track concept describes the dynamic interaction of bipolar bone loss in anterior glenohumeral instability. Initial studies have successfully demonstrated this concept’s application in clinical populations. In clinical practice, the Latarjet procedure is commonly the preferred treatment in addressing “off-track” Hill-Sachs lesions. The effectiveness of this procedure in restoring such lesions to an “on-track” state, however, has not yet been evaluated or described in the literature. Hypothesis: The Latarjet procedure would transform “off-track” Hill-Sachs lesions to “on-track” lesions. Lesions would remain “on-track” during follow-up, despite glenoid remodeling. Study Design: Case series; Level of evidence, 4. Methods: Patients with “off-track” Hill-Sachs lesions treated with the arthroscopic Latarjet procedure between March 2013 and May 2014 were included. Glenoid track and coracoid graft contact surface area measurements using 3-dimensional computed tomography (3D-CT) were performed preoperatively and at 6-week, 6-month, and at least 12-month (final) follow-up. The mean final follow-up was 23 months. The glenoid diameter, as a percentage of the native glenoid, was also calculated from this imaging. Results: Twenty-six patients met the inclusion criteria. 3D-CT scans were available for all patients preoperatively and postoperatively, with 21 patients (81%) undergoing 6-month follow-up CT and 19 patients (73%) undergoing final follow-up CT. Hill-Sachs lesions remained “on-track” at all follow-up time points. The mean glenoid diameter changed significantly from 84.6% preoperatively to 122.8% at 6 weeks ( P < .001) and from 120.5% at 6 months to 113.9% at final follow-up ( P = .005). This was also reflected in significant remodeling seen in the coracoid graft articular contact area (6 weeks to 6 months, P = .024; 6 months to final follow-up, P = .002). This persisting glenoid arc enlargement at final follow-up avoided “off-track” Hill-Sachs lesions in 6 of 19 patients (32%), which would otherwise have occurred had the coracoid graft remodeled to native glenoid dimensions. Conclusion: The Latarjet procedure provides an effective treatment for “off-track” engaging Hill-Sachs lesions, despite an evident glenoid remodeling process. At a mean of 23 months postoperatively, a mean persisting enlargement of the glenoid arc of 14% beyond native dimensions remained, avoiding a recurrent “off-track” lesion in 32% of patients, which would otherwise have occurred with complete remodeling.


2019 ◽  
Vol 13 (2) ◽  
pp. 154-159
Author(s):  
Luis Paulo Vilela Lemos ◽  
Tiago Soares Baumfeld ◽  
Benjamim Dutra Macedo ◽  
Caio Augusto De Souza Nery ◽  
Jorge P. Batista ◽  
...  

Objective: Fifth metatarsal fractures occur mainly in young athletes, with an estimated incidence of 1.8 per 1,000 people a year. The objective of this study was to evaluate the functional outcome of professional soccer players subjected to surgical treatment of fifth metatarsal base fractures. Methods: A total of 34 soccer players who underwent surgery from July 2001 to June 2016 were evaluated. All participants were evaluated by the American Orthopedic Foot and Ankle Score (AOFAS) and visual analogue scale (VAS) score before and after surgery, with a mean follow-up of 23 months. The need for grafting relative to time to surgery, time to fracture consolidation and Torg classification and graft use relative to return to sport were valuated. Results: There were 10 forwards, 7 offensive midfielders, 6 fullbacks, 5 center midfielders, 3 defenders, 2 goalkeepers and 1 defensive midfielder, with a mean age of 19 years. The mean pre- and postoperative AOFAS was 42 and 99 points whereas the mean VAS score was 6 and 0, respectively. The longer the time to surgery, the greater was the need for grafting (p=0.011). The time to return to sport was not influenced by the time to surgery, time to consolidation, Torg classification or graft use. Conclusion: The surgical treatment of fifth metatarsal base fractures in professional soccer players showed good clinical results. The return to activities after surgery is not influenced by the time to surgery, time to consolidation, Torg classification or grafting. Level of Evidence IV; Therapeutic Studies; Case Series.


2021 ◽  
Author(s):  
Mingtao Zhang ◽  
Zhitao Yang ◽  
Jiaxin Liu ◽  
Yaofei Jia ◽  
Guangrui Zhang ◽  
...  

Abstract BackgroundGenerally, the treatment of recurrent anterior shoulder instability is a challenge in the orthopedics with various treatment methods. There is a high recurrence rate for those patients with high activity and glenoid bone lesion less than 20% after Bankart procedure. The authors present a novel surgical technique using autologous osteochondral transplantation (AOT) method for recurrent anterior shoulder instability.MethodsBetween 2019 to 2021, 7 patients (five man and two women; mean age 35.1 years (range 17–55 years)) with recurrent anterior shoulder instability and glenoid bone lesion of 20% or less were treated with AOT method. All patients were available for follow-up at a mean of 25.4 months (range, 16 to 32 months), including Rowe score, Oxford Shoulder Score (OSS), Simple Shoulder Test (SST), and 3-dimensional computed tomography examination.ResultsThe mean preoperative and postoperative Rowe score were calculated to be 25.7 ± 6.7 (range, 20–35) and 90.6 ± 2.4 (range, 85–95), respectively (p < 0.01). The mean preoperative and postoperative Oxford score were 36.4 ± 5.6 (range, 30–40) and 54.6 ± 2.4 (range, 50–57), respectively (p < 0.01). The mean preoperative and postoperative SST score were 6.9 ± 0.7 (range, 6–8) and 11.5 ± 0.7 (range, 11–12), respectively (p < 0.01). The average final forward flexion was 176° (affected shoulder), compared with 177° on the non-affected shoulder (P = 0.81). The average final abduction in external rotation was 86.6° (affected shoulder), compared with 89° on the non-affected shoulder (P = 0.31). Analysis of Computed Tomography (CT) data at an average 1 years postoperative showed that a mean glenoid bony gain of 16.7% was observed (range, 11.2%-19%, SD 3.6).ConclusionThis technique can be a useful option, particularly in patients with glenoid bone defect less than 20%. In addition, AOT technique may be considered as alternative to the Latarjet procedure. Nonetheless, further biomechanical and clinical studies are needed to determine the effect of this procedure to more commonly utilized techniques.Level of EvidenceLevel IV; Case series


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