Incidence of Progressive Osteoarthritis Following Latarjet Procedure for Shoulder Instability
The incidence of progressive osteoarthritis following the Latarjet procedure ranges from 8-42% at 5-year follow-up and 9-71% at 10-year follow-up, with most cases being mild (grade 1) osteoarthritis. 1
Prevalence and Severity of Post-Latarjet Osteoarthritis
The development of glenohumeral osteoarthritis following the Latarjet procedure is a recognized long-term complication, but its prevalence varies across studies:
- A 2023 study with 22-year follow-up found an osteoarthritis rate of 34.1% 2
- A systematic review of studies with minimum 5-year follow-up found osteoarthritis rates of 25.8%, with 88.6% of these cases being mild (grade 1) according to the Samilson and Prieto classification 3
- Another long-term study with 20-year follow-up reported that:
- 20% of shoulders without preoperative arthritis developed it postoperatively
- 50% of shoulders with preoperative arthritis showed progression
- Overall distribution: 14.7% stage 1,5.9% stage 2,8.8% stage 3, and no stage 4 arthritis 4
Risk Factors for Osteoarthritis Development
Several factors influence the development or progression of osteoarthritis after the Latarjet procedure:
Surgical Factors (Modifiable)
- Lateral bone graft overhang: This is the most significant surgical risk factor 2, 3, 4
- 71.4% osteoarthritis rate with lateral overhang vs. 16.7% with medial or flush bone block positioning 2
Patient Factors (Non-modifiable)
- Advanced age at surgery 2, 4
- Age >30 years at first instability episode 2
- High-demand sports activity 4
Protective Factors
- Hyperlaxity appears to have a protective role against osteoarthritis development 3
Non-significant Factors
- Number of dislocations before surgery 2, 3
- Presence of Hill-Sachs lesion 3
- Gender 3
- Time between first dislocation and surgery 3
Clinical Impact of Post-Latarjet Osteoarthritis
Despite the development of radiographic osteoarthritis, the clinical impact appears limited:
- The clinical impact of osteoarthritis is significant only in advanced stages (Samilson 3 and 4) 2
- Patient satisfaction remains high (90.9%) even at long-term follow-up 2
- Good functional outcomes persist with mean Constant scores of 83.5±14 and Walch-Duplay scores of 71.6±23.4 at 22-year follow-up 2
- Recurrent instability rates remain low (1.59-5.9%) at long-term follow-up 4, 5
Clinical Implications and Recommendations
Based on these findings:
- Surgeons should prioritize accurate coracoid graft positioning, ensuring it is flush with the glenoid rim rather than laterally overhanging
- Specific instrumentation and arthroscopic techniques may facilitate optimal graft positioning 2
- Patients should be counseled about the risk of developing mild osteoarthritis over time, but reassured that this rarely impacts function significantly
- Younger patients (<30 years at first instability) may have lower risk of developing osteoarthritis
- Regular radiographic follow-up is warranted to monitor for arthritis development or progression
The Latarjet procedure remains a valid and safe surgical treatment for recurrent anterior shoulder instability with a low risk of developing moderate or severe osteoarthritis, even at long-term follow-up 3.