BACKGROUND: Several papers have shown that shoulder stabilizing procedures, including the Latarjet procedure, lead to postoperative external rotation (ER) deficits. However, no study on arthroscopic Latarjet procedures has investigated the effect on ER when the arm is abducted at 0° and 90°. This study examined the relationship between the arthroscopic Latarjet procedure and the subsequent effect on external rotation at both 0° and 90° of abduction compared to the contralateral extremity. METHODS: Records of patients who underwent an arthroscopic Latarjet Procedure from December 2015 to April 2021 were retrospectively evaluated for this study. Requirements included both a three- and six-month follow-up visit. Any procedure that was done open or was a combined open-arthroscopic approach was excluded. Patients were also excluded if they had a previous surgery on the contralateral shoulder as this extremity was used for external rotation comparison. Preoperative range of motion (ROM) including ER with the arm adducted by the patient’s side (ER0) and ER at 90° abduction (ER90) were obtained from the contralateral shoulder. External rotation values of the operative side were subsequently collected at both the three- and six- month postoperative appointments. A repeated measures ANOVA was performed to assess the mean values between the preoperatively measured contralateral extremity and the operative extremity as measured at both the three- and six-month timeframes. Statistical significance was set at p<0.05. RESULTS: Forty-six patients met the inclusion criteria. Mean ER0 for the three- and six-month time frames measured 44.2° and 54.6°, respectively. Mean ER90 for the three- and six-month timeframes measured 78.4° and 90.4°, respectively. Comparison to the contralateral arm at the three-month follow-up period showed a deficit of 14.9° (p=0.0001) and 17.2° (p=0.0001) for ER0 and ER90, respectively. At the six-month follow-up period, patients demonstrated an average decline in ER0 and ER90 of 4.57° (p=0.063) and 5.11° (p=0.008), respectively. CONCLUSION: A nominal deficit in external rotation occurred at both 0° and 90° of shoulder abduction status post arthroscopic Latarjet procedure. Although the loss was only 5.11°, there was a significant loss of range of motion between the six-month ER90 of the operative extremity versus the preoperative contralateral extremity. Despite loss of ER90 at six-months achieving statistical significance, the clinical impact is arguably inconsequential. Regaining range of motion including ER at 0° and 90° provides more information regarding bony procedures being a more definitive treatment for glenohumeral instability and the ability to restore native motion.
Bodine ME, Bishai SK, Ball G, King C, Wait L, Brannan G. A retrospective evaluation of external rotation at 0 degree and 90 degrees of abduction after arthroscopic Latarject procedure. Presented at: Mid-American Orthopaedic Association 40th Annual Meeting; 2023 Apr 19-23; Miramar Beach, FL. Available from: https://maoa.memberclicks.net/assets/Abstracts/MAOA%202023%20abstracts.pdf