School of Medicine and Health Sciences Poster Presentations

Title

The Latarjet procedure for anterior glenohumeral instability recurrence in the setting of the US military; a retrospective case series

Document Type

Poster

Keywords

Latarjet; glenohumeral; shoulder; instability; military

Publication Date

Spring 2017

Abstract

Introduction

Glenohumeral (shoulder) instability is one of the most common pathologies seen by orthopedic sports medicine surgeons. The US Military is a unique, high-demand, physically active population with high rates of glenohumeral instability. Glenoid bone augmentation procedures are the gold standard treatment for recurrent anterior shoulder instability in the setting of glenoid bone loss greater than 15-20%. The Latarjet procedure, along with various modifications, is one possible stabilization procedure available to surgeons. However, complications and outcomes related to this procedure are not well understood in the military population. Therefore, the purpose of this study was to report complication rates, recurrent instability, and revision surgery following a Latarjet in the military population.

Methods

The Military Health System Data Repository (MDR) was queried to identify all active duty military personnel who underwent a Latarjet procedure for recurrent anterior shoulder instability between January 1, 2004 and December 31, 2015. Following identification of these individuals, we collected demographic information, nature of the initial injury, prior history of surgeries on the affected shoulder, and outcomes, including complications, recurrent instability events, and revision surgery.

Results

A total of 217 (212 male, 5 female; mean age = 26.2 years) patients were identified. The majority of procedures (52.3%) were performed on the dominant shoulder. Most patients (55.8%) experienced both subluxations and dislocations, while 27.2% and 14.8% reported only subluxations or dislocations, respectively. In 2.3% of patients, there was not clear documentation of a previous instability event. 59.0% of patients had a previous stabilization surgery and required revision to Latarjet, and 28.1% of patients had more than 1 previous stabilization procedure. Following the Latarjet, 8.8% reported a recurrent instability episode; the majority of these instability episodes were subjective subluxation events as opposed to frank dislocations. 11.1% of patients required an additional procedure after the Latarjet, most commonly a revision to the original procedure, as some did not report an actual instability event.

Conclusions

Indications for certain surgical procedures among military service requires high-impact physical activity that expose service-members to a higher risk of shoulder instability. In the presence of glenoid bone loss, the Latarjet is the most commonly used surgical procedure for glenoid augmentation. This study has demonstrated that despite an overall high demand occupation, recurrent shoulder dislocation rates are low and reliably restore shoulder stability. We recommend continued investigation of patient outcomes through a patient reported outcomes database and further clinical investigations.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster to be presented at GW Annual Research Days 2017.

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The Latarjet procedure for anterior glenohumeral instability recurrence in the setting of the US military; a retrospective case series

Introduction

Glenohumeral (shoulder) instability is one of the most common pathologies seen by orthopedic sports medicine surgeons. The US Military is a unique, high-demand, physically active population with high rates of glenohumeral instability. Glenoid bone augmentation procedures are the gold standard treatment for recurrent anterior shoulder instability in the setting of glenoid bone loss greater than 15-20%. The Latarjet procedure, along with various modifications, is one possible stabilization procedure available to surgeons. However, complications and outcomes related to this procedure are not well understood in the military population. Therefore, the purpose of this study was to report complication rates, recurrent instability, and revision surgery following a Latarjet in the military population.

Methods

The Military Health System Data Repository (MDR) was queried to identify all active duty military personnel who underwent a Latarjet procedure for recurrent anterior shoulder instability between January 1, 2004 and December 31, 2015. Following identification of these individuals, we collected demographic information, nature of the initial injury, prior history of surgeries on the affected shoulder, and outcomes, including complications, recurrent instability events, and revision surgery.

Results

A total of 217 (212 male, 5 female; mean age = 26.2 years) patients were identified. The majority of procedures (52.3%) were performed on the dominant shoulder. Most patients (55.8%) experienced both subluxations and dislocations, while 27.2% and 14.8% reported only subluxations or dislocations, respectively. In 2.3% of patients, there was not clear documentation of a previous instability event. 59.0% of patients had a previous stabilization surgery and required revision to Latarjet, and 28.1% of patients had more than 1 previous stabilization procedure. Following the Latarjet, 8.8% reported a recurrent instability episode; the majority of these instability episodes were subjective subluxation events as opposed to frank dislocations. 11.1% of patients required an additional procedure after the Latarjet, most commonly a revision to the original procedure, as some did not report an actual instability event.

Conclusions

Indications for certain surgical procedures among military service requires high-impact physical activity that expose service-members to a higher risk of shoulder instability. In the presence of glenoid bone loss, the Latarjet is the most commonly used surgical procedure for glenoid augmentation. This study has demonstrated that despite an overall high demand occupation, recurrent shoulder dislocation rates are low and reliably restore shoulder stability. We recommend continued investigation of patient outcomes through a patient reported outcomes database and further clinical investigations.