Travis L. Frantz
BOSTON — A large percentage of athletes fail to return to full baseline strength and range of motion 6 months after Latarjet procedure, according to data presented at the American Orthopaedic Society for Sports Medicine Annual Meeting.
“Greater preoperative stiffness, subjective disability and greater than 1-year duration of symptoms do appear to be risk factors for failing to meet the return-to-sport criteria. Knowing that many athletes return to sport, even in this study, in 6 months, we must be critical of our return-to-play criteria and perhaps consider transitioning away for straight biologic measures and toward more sport-specific measures,” Travis L. Frantz, MD, said.
In the multicenter, prospective cohort study at 10 participating sites in the United States, the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group Cohort Study reviewed 65 patients who participated in either contact or overhead sports and underwent the Latarjet procedure for anterior shoulder instability. Latarjet was the primary operation for 19 patients and 46 patients were a revision surgery case. Overall, 10% of patients had less than 10% anterior glenoid bone loss; 55% had 11% to 20% anterior glenoid bone loss; and 35% had 21% to 30% anterior glenoid bone loss. Latarjet procedure was performed with subscapularis tenotomy or subscapularis split.
Researchers assessed preoperative and postoperative strength and range of motion, and defined return-to-play (RTP) criteria as full strength and less than 20 side-to-side range-of-motion deficits in all planes.
At 6-month follow-up, Frantz said no episodes of recurrent instability were reported; however, 55% of patients failed to meet one or more of the RTP criteria, with the majority for stiffness or lack of more than 20 side-to-side loss of motion. There was no difference for patients reaching RTP criteria with subscapularis split vs. tenotomy. Return-to-play was 53% for contact athletes and was 67% for overhead athletes.
Frantz said preoperative weakness was not predictive of postoperative weakness, and preoperative external rotation was not predictive of deficient in postoperative external rotation. Percent bone loss was not predictive of side-to side postoperative ROM deficits or weakness, he said. – by Kristine Houck, MA, ELS
Frantz TL, et al. Abstract 28. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2019; Boston.
Disclosure: Frantz reports no relevant financial disclosures.