Long-term outcomes of the congruent arc Latarjet procedure: evaluation of 136 patients with a minimum follow-up of 10 years.

Abstract

Although the congruent arc Latarjet (CAL) surgery has shown to be an effective treatment for the management of recurrent glenohumeral instability in the short term, there are no studies in the literature evaluating its long-term results. This study aimed to assess the functional outcomes, complications, and revision rates in a consecutive series of athletes with recurrent glenohumeral instability who underwent surgery with the CAL technique and who were followed up for a minimum period of 10 years. Between June 2008 and June 2014, 136 athletes with recurrent glenohumeral instability were treated at our institution with the CAL surgery. In total, 70 primary procedures and 63 revision procedures were included. We evaluated return to sport and used the Rowe, visual analogue scale, Athletic Shoulder Outcome Scoring System, and Single Assessment Numeric Evaluation scores to assess functional outcomes. Complications and revisions were evaluated. Graft consolidation was evaluated with computed tomography at 3 months. Osteoarthritis was evaluated at the final follow-up with radiographs according to the Samilson Prieto classification. The final analysis included 136 patients (follow-up 93%). The average follow-up was 140 months (range: 120-158 months) and the average age at the time of surgery was 23.2 years (range: 17-35 years). Overall, 94% of patients returned to sports and 90% returned to the same level as before surgery. The mean Rowe, visual analog scale, and American Shoulder and Elbow Surgeons scores at 140-month follow-up were 85, 1.5, and 80, respectively, all improved significantly compared to the preoperative (P < .01). The average Single Assessment Numeric Evaluation score was 85%. Moreover, 94% and 96% of the patients had a Rowe and American Shoulder and Elbow Surgeons score that exceeded the minimal clinically important difference, respectively. The bone graft consolidated in 92% of the patients. The recurrence rate was 6% and the revision rate was 3%. At the end of follow-up, 26% of the patients had osteoarthritic changes. There were no significant differences in functional scores between patients who presented arthritic changes and those who did not. The CAL is associated with a high percentage of return to sport, excellent functional outcomes, and a low rate of recurrences after a minimum follow-up of 10 years. Although 26% of patients had osteoarthritic changes at the end of follow-up, most were mild and moderate, without significant differences in functional scores between patients who presented arthritic changes and those who did not.