SURGICAL TREATMENT OF ANTERIOR SHOULDER INSTABILITY IN RUGBY PLAYERS: CLINICAL AND RADIOGRAPHIC RESULTS OF THE LATARJET-PATTE PROCEDURE WITH MINIMUM FIVE-YEAR FOLLOW-UP

Authors: L Neyton; B Dawidziak; E Visona; JP Hager; Y Fournier; G Walch

References: Presented at SECEC 2009

Purpose
The goal of the study is to report clinical and radiological results of the Latarjet-Patte procedure in the treatment of recurrent traumatic anterior instability in rugby players with a minimum of five year follow-up. The triple block effect (bone, capsule, muscle) provided by the Latarjet-Patte procedure is effective in the treatment of recurrent anterior instability in high demanding contact sports such as rugby.

Material and Methods
Thirty-four rugby players (37 shoulders) were included. Mean age at surgery was 23.4 years (17-33). A bony lesion of the glenoid was present in 73% and Hill-Sachs lesion in 68%.

Results
At mean follow-up of 144 months (68-237), no recurrence was observed (dislocation or subluxation). Persistent apprehension was present in five patients (14%). Sixty-five percent of the patients returned to rugby. One patient did not return playing rugby because of the operated shoulder. Mean Walch-Duplay and Rowe score was 86 and 93 points, respectively. Ninety-four percent were satisfied with the result. The coracoid was healed on the glenoid in 89% (3 fractures, 1 non-union). Twenty-six shoulders (70%) had no arthritis and eleven (30%) had grade 1 lesions according to Samilson-Prieto.

Conclusion
Anterior instability in rugby players is characterized by an increased frequency of bony lesions on the glenoid or humeral side which are identified as potential causes of recurrence after surgery with capsular or labral based repairs. In this series, the Latarjet-Patte procedure provided a stable shoulder and a return to rugby in a high number of cases without long term arthritic degeneration. These results lead us to systematically propose anterior bone block Latarjet-Patte procedure in the treatment of recurrent anterior instability in rugby players.