Return to Sports after Latarjet Surgery: Systematic Literature Review
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Published:
Apr 14, 2021
Keywords:
Glenohumeral instability, return to sports, Latarjet
Main Article Content
Abstract
Background: The purpose of this study was to describe rates of return to sports and the level achieved by patients after the Latarjet procedure.
Methods: We followed a protocol registered in PROSPERO (registration number CRD42018107606). A search of the literature was performed on May 2019 in MEDLINE, EMBASE, CENTRAL and clinical trials records. We used the GRADE approach for the assessment of the overall quality of the evidence per outcome. We included studies (Level I to IV evidence) evaluating return to sports following shoulder stabilization with the Latarjet procedure with a minimum of 2-year follow-up.
Results: We included 24 studies, including 1436 athletes, all treated surgically after a median follow-up of 57 months (range 24 to 240). The overall rate of return to sport ranged from 65% to 100%, including 23% to 100% at an equivalent level of play. The mean time for return to play was 6 months (range, 1 - 36 months). Competitive athletes appeared to return to the same level of play and this difference was not statistically significant (p = 0.32). The quality of the evidence was very low due to study design (level IV evidence), study limitations and inconsistency.
Conclusion: Most athletes with glenohumeral instability returned to sport, however the level maintained after shoulder stabilization with the Latarjet procedure varied substantially. The mean time to return to sports was 6 months and results were equally favorable in competitive and recreational athletes.
Methods: We followed a protocol registered in PROSPERO (registration number CRD42018107606). A search of the literature was performed on May 2019 in MEDLINE, EMBASE, CENTRAL and clinical trials records. We used the GRADE approach for the assessment of the overall quality of the evidence per outcome. We included studies (Level I to IV evidence) evaluating return to sports following shoulder stabilization with the Latarjet procedure with a minimum of 2-year follow-up.
Results: We included 24 studies, including 1436 athletes, all treated surgically after a median follow-up of 57 months (range 24 to 240). The overall rate of return to sport ranged from 65% to 100%, including 23% to 100% at an equivalent level of play. The mean time for return to play was 6 months (range, 1 - 36 months). Competitive athletes appeared to return to the same level of play and this difference was not statistically significant (p = 0.32). The quality of the evidence was very low due to study design (level IV evidence), study limitations and inconsistency.
Conclusion: Most athletes with glenohumeral instability returned to sport, however the level maintained after shoulder stabilization with the Latarjet procedure varied substantially. The mean time to return to sports was 6 months and results were equally favorable in competitive and recreational athletes.
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How to Cite
Tanoira, I., Rossi, L., Franco, J. V. A., Escobar Liquitay, C. M., Pasqualini, I., & Ranalletta, M. (2021). Return to Sports after Latarjet Surgery: Systematic Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(2), 263-280. https://doi.org/10.15417/issn.1852-7434.2021.86.3.1068
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Revisión Sistemática
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recurrent anterior shoulder instability with bipolar bone loss: a systematic review to assess critical bone loss
amounts. Am J Sports Med 2018;27:363546518791555. https://doi.org/10.1177/0363546518791555
2. Willemot LB, Elhassan BT, Verborgt O. Bony reconstruction of the anterior glenoid rim. J Am Acad Orthop Surg 2018;26(10):e207-e218. https://doi.org/10.5435/JAAOS-D-16-00649
3. Degen RM, Camp CL, Werner BC, Dines DM, Dines JS. Trends in bone-block augmentation among recently
trained orthopaedic surgeons treating anterior shoulder instability. J Bone Joint Surg Am 2016;98(13):e56.
https://doi.org/10.2106/JBJS.15.01478
4. Rabinowitz J, Friedman R, Eichinger JK. Management of glenoid bone loss with anterior shoulder instability:
indications and outcomes. Curr Rev Musculoskelet Med 2017;10(4):452-62.
https://doi.org/10.1007/s12178-017-9439-y
5. Riff AJ, Frank RM, Sumner S, Friel N, Bach BR Jr, Verma NN, Romeo AA. Trends in shoulder stabilization
techniques used in the United States based on a large private-payer database. Orthop J Sports Med
2017;5(12):2325967117745511. https://doi.org/10.1177/2325967117745511
6. Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a
systematic review. Orthop J Sports Med 2018;6(7):2325967118786930. https://doi.org/10.1177/2325967118786930
7. Dines JS, Dodson CC, McGarry MH, Oh JH, Altchek DW, Lee TQ. Contribution of osseous and
muscular stabilizing effects with the Latarjet procedure for anterior instability without glenoid bone loss. J Shoulder Elbow Surg 2013;22(12):1689-94. https://doi.org/10.1016/j.jse.2013.02.014
8. Yamamoto N, Muraki T, An KN, Sperling JW, Cofield RH, Itoi E, et al. The stabilizing mechanism of
the Latarjet procedure: a cadaveric study. J Bone Joint Surg Am 2013;95(15):1390-7. https://doi.org/10.2106/JBJS.L.00777
9. An VV, Sivakumar BS, Phan K, Trantalis J. A systematic review and meta-analysis of clinical and patient-reported
outcomes following two procedures for recurrent traumatic anterior instability of the shoulder: Latarjet procedure vs. Bankart repair. J Shoulder Elbow Surg 2016;25(5):853-63. https://doi.org/10.1016/j.jse.2015.11.001
10. Lädermann A, Böhm E, Tay E, Scheibel M. Bone-mediated anteroinferior glenohumeral instability : Current
concepts. Orthopade 2018;47(2):129-38. https://doi.org/10.1007/s00132-017-3511-6
11. Porter DA, Birns M, Hobart SJ, Kowalsky M, Galano GJ. Arthroscopic treatment of osseous instability of the
shoulder. HSS J 2017;13(3):292-301. https://doi.org/10.1007/s11420-017-9553-9
12. Tjong VK, Devitt BM, Murnaghan ML, Ogilvie-Harris DJ, Theodoropoulos JS. A qualitative investigation of return to sport after arthroscopic Bankart repair: beyond stability. Am J Sports Med 2015;43(8):2005-11.
https://doi.org/10.1177/0363546515590222
13. Higgins JPT, Lasserson T, Chandler J, Tovey D, Churchill R. Methodological Expectations of Cochrane Intervention [Internet]. London: Cochrane; Version July 2019. Standards for the conduct of new Cochrane Intervention (C1-75). [cited 2019 sept 03]. Disponible en:
https://community.cochrane.org/mecir-manual/standards-conduct-new-cochrane-intervention-reviews-c1-75
14. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Disponible en: www.handbook.cochrane.org
15. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and metaanalyses: the PRISMA statement. Int J Surg 2010;8:336-41. https://doi.org/10.1016/j.ijsu.2010.02.007
16. Moga C, Guo B, Schopflocher D, Harstall C. Development of a quality appraisal tool for case series studies using a modified Delphi technique [Internet]. Edmonton AB: Institute of Health Economics; 2012:71 [cited 2019 sept 03]. Disponible en: https://www.ihe.ca/advanced-search/development-of-a-quality-appraisal-tool-for-case-series-studies-using-a-modified-delphi-technique
17. Schünemann H, Brożek J, Guyatt G, Oxman A (eds). Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach. Updated October 2013 [Internet]. The GRADE Working Group; 2013 [cited 2019 sept 03]. Disponible en: https://gdt.gradepro.org/app/handbook/handbook.html#h.hnedbo8gqjqk
18. El Andaloussi Y, Arssi M, Zaouari T, Benhima MA, Cohen D, Trafeh M, et al. Instabilité antérieure de l’épaule chez les sportifs À propos de 36 cas. J Traumatol Sport 2006;23:148-52. https://doi.org/10.1016/S0762-915X(06)71431-0
19. Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Public Health 2014;72(1):39. https://doi.org/10.1186/2049-3258-72-39
20. Baverel L, Colle PE, Saffarini M, Anthony Odri G, Barth J. Open Latarjet procedures produce better outcomes in competitive athletes compared with recreational athletes: a clinical comparative study of 106 athletes aged under 30 years. Am J Sports Med 2018;46(6):1408-15. https://doi.org/10.1177/0363546518759730
21. Higgins JPT, Green S (eds). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011][Internet]. The Cochrane Collaboration; 2011. Chapter 9, Analysing data and undertaking metaanalyses. [cited 2019 sept 03]. Disponible en: www.handbook.cochrane.org
22. Cote MP, Lubowitz JH, Rossi MJ, Brand JC. Reviews pooling heterogeneous, low-evidence, high-bias data result in incorrect conclusions: but heterogeneity is an opportunity to explore. Arthroscopy 2018;34(12):3126-8.
https://doi.org/10.1016/j.arthro.2018.10.005
23. Harris JD, Brand JC, Cote MP, Faucett SC, Dhawan A. Research pearls: the significance of statistics and perils of
pooling. Part 1: Clinical versus statistical significance. Arthroscopy 2017;33(6):1102-12. https://doi.org/10.1016/j.arthro.2017.01.053
24. Hunter JP, Saratzis A, Sutton AJ, Boucher RH, Sayers RD, Bown MJ. In meta-analyses of proportion studies, funnel plots were found to be an inaccurate method of assessing publication bias. J Clin Epidemiol 2014;67(8):897-903. https://doi.org/10.1016/j.jclinepi.2014.03.003
25. GRADEpro GDT [Software]. McMaster University and Evidence Prime; c2015 [cited 2019 Sep 03]. Disponible
en: gradepro.org
26. Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP. Results of modified Latarjet
reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy 2007;23:1033-41.
https://doi.org/10.1016/j.arthro.2007.08.009
27. Neyton L, Dagher E, Jouve F, Josserand LN, Walch G. Chronic anterior glenohumeral instability in rugby player.
Series of 85 Latarjet procedures with medium follow-up of seven years. J Traumatol Sport 2007;24(3):122-7.
https://doi.org/10.1016/j.jts.2007.06.007
28. Neyton L, Young A, Dawidziak B, Visona E, Hager J-P, Fournier Y, et al. Surgical treatment of anterior instability in Rugby Union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year followup. J Shoulder Elbow Surg 2012;21:1721-7. https://doi.org/10.1016/j.jse.2012.01.023
29. Bessiere C, Trojani C, Pélégri C, Carles M, Boileau P. Coracoid bone block versus arthroscopic Bankart repair: a
comparative paired study with 5-year follow-up. Orthop Traumatol Surg Res 2013;99(2):123-30.
https://doi.org/10.1016/j.otsr.2012.12.010
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