Gleno-humeral arthritis following latarjet procedure: Risk-factors, progression and its impact on clinical outcome.

Abstract

Objective: To assess the postoperative glenohumeral arthritis following latarjet procedure: in terms of its prevalence, risk-factors and role in functional recovery. Study Design: Descriptive Case Series. Setting: Ghurki Trust Teaching Hospital, Lahore. Period: 01/06/2022 to 30/11/2022. Methods: Forty-one patient who underwent latarjet procedure were retrospectively assessed Arthritis staging was done as per Samilson and Preito classification and outcome was assessed in terms of pain (VAS), UCLA score and Rowe score. Results: All the three aforementioned outcome score showed a statically significant (p<0.001) improvement in mean measurement from 2.9, 20.82 and 33.41 to 1.36, 31.09 and 85.97 respectively for pain, UCLA and Rowe score. Nine patients had arthritic changes before surgical intervention whereas five developed arthritis in non-arthritic joints. Improvement in all the three outcome measures was noted in both arthritic and non-arthritic shoulders: however, mean improvement in pain, UCLA and Rowe scores were significantly lower (p<0.001) in arthritic (2.428, 28.28 and 79.64) as compared to non-arthritic shoulders (i-e 0.814, 32.55 and 89.25 respectively). Not only this, but the postoperative scores were dependent on the stage of arthritis. Factors found associated with progression of arthritis included number of preoperative dislocations (p=0.009), age at time of the procedure (p<0.001) and coracoid graft’s lateral overhang (p=0.002). Conclusion: Latarjet procedure has excellent clinical results: however, it predisposes to postoperative arthritis; where preoperative dislocations, age and coracoid-graft’s lateral-overhang are risk factors for the complication.