Open Latarjet Procedure in Athletes following Failed Prior Instability Surgery results in Lower Rates of Return to Play.

PURPOSE: The purpose of this study was to compare the outcomes of open Latarjet (OL) in competitive athletes with primary shoulder instability versus those with recurrent instability versus those undergoing OL for failed prior instability surgery.
METHODS: A retrospective review of patients who underwent OL with a minimum of 24-month follow-up was performed. Additionally, these were pair matched in a 1:2:1 ratio for age, gender, sport, level of pre-operative play, and follow-up length for primary instability, recurrent instability and failed prior instability surgery. Return to sport, the level of return and the timing of return were assessed. Additionally, recurrence, Visual Analogue Scale for pain (VAS), Subjective Shoulder Value (SSV), Rowe score, Shoulder Instability-Return to Sport after Injury (SIRSI) score, satisfaction, and whether they would undergo the same surgery again were compared.
RESULTS: Following pair-matching, a total of 200 patients were included, with a mean age of 22.7 years and a mean follow-up of 38.8 months. Overall, there was no significant difference in any of the clinical outcome scores (VAS, Rowe, SIRSI, SSV) utilized for the three groups (p > 0.05 for all). However, there was a significantly lower rate of return to play for those undergoing OL for failed prior instability surgery (88% vs 91% vs 64%, p < 0.0001), and for return at the same/higher level (66% vs 78% vs 56%, p = 0.02). There was no significant difference in the rate of recurrent instability between the three groups (6% vs 5% vs 6%, p = 0.95).
CONCLUSION: OL results in excellent clinical outcomes, and low recurrence rates for primary shoulder instability, those with recurrent instability, or those undergoing OL for failed prior instability surgery. However, in those undergoing OL for failed prior stabilization surgery there was a lower rate of return to play.