Favorable Functional Outcomes and Low Instability Recurrence Rates After the Latarjet Procedure in Adolescent Patients: A Systematic Review.

PURPOSE: To assess clinical, functional, and radiographic outcomes as well as return-to-sports (RTS) rates in adolescent patients (aged 10-19 years according to the World Health Organization) who underwent the Latarjet procedure.

METHODS

A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020) guidelines and was prospectively registered on PROSPERO-International Prospective Register of Systematic Reviews (reference: CRD420251003844). A systematic search of the databases PubMed, Web of Science (Clarivate Analytics), Scopus, and Google Scholar was performed, and clinical studies reporting outcomes of adolescent patients aged 10 to 19 years who underwent the Latarjet procedure for the treatment of anterior shoulder instability with a minimum follow-up of 2 years were included. Studies were excluded if adolescent patients were part of a larger study cohort, but the outcomes were not reported separately. Demographic and surgical data, clinical outcomes, such as instability recurrence, revisions, and overall complication rates, functional outcomes, RTS rates, and radiological outcomes were extracted from each study. Moreover, a descriptive synthesis of the results and analysis of heterogeneity was performed.

RESULTS

Eight retrospective studies (6x Level III, 2x Level IV), comprising 265 shoulders in 262 patients, were included. The mean age at surgery ranged from 15.7 to 18.0 years and mean follow-up ranged from 3.3 to 11.3 years. The rate of recurrent instability ranged from 3.3% to 14.3%, and the revision rate for instability ranged from 0% to 8.3%. The overall complication rate ranged from 6.7% to 25.8%, with screw irritation being reported most frequently. Favorable postoperative patient-reported outcome measures were reported overall, including a mean subjective shoulder value ranging from 86.2 to 94.0 and a mean Rowe score ranging from 80.0 to 94.0. RTS rates ranged from 71.4% to 100%, with 75.0% to 79.2% of patients returning to their preoperative level of play. Coracoid graft union rates were less consistent (mean 66.7%-100%). Substantial heterogeneity was observed regarding patient populations, surgical indications, and techniques and types of outcome measures.

CONCLUSIONS

The Latarjet procedure yields favorable clinical and functional outcomes as well as high RTS rates in adolescent patients. Graft union rates varied but were generally high. The available evidence, however, is limited to retrospective studies with considerable heterogeneity regarding patient populations, surgical indications, and techniques and types of outcome measures assessed.

LEVEL OF EVIDENCE: Level IV, systematic review of Level III to IV studies.