Latarjet after Failed Arthroscopic Bankart Repair Results in Twice the Rate of Recurrent Instability Compared to Primary Latarjet

The purpose of this study was to assess recurrent instability of the shoulder following open Latarjet performed as the primary stabilization procedure or as a salvage procedure. A retrospective, comparative cohort study was performed for a consecutive series of patients in the Military Health System who underwent open Latarjet from January 1, 2010 to December 31, 2018. All patients were diagnosed with recurrent anterior shoulder instability and had a minimum of two years of postoperative follow-up. Patients were categorized as either having a primary Latarjet (PL) - defined as no prior shoulder stabilization procedure - or salvage Latarjet (SL) - defined as having at least one previous arthroscopic surgical stabilization procedure. A total of 234 Latarjet procedures were performed in 234 patients. The overall recurrent instability rate was 15.8% (37/234), the overall reoperation rate was 16.7% (36/234), and the overall complication rate was 14.2% (33/234) over a mean 5.0 years of follow-up. There were 99 primary Latarjet (PL) procedures and 135 salvage Latarjet (SL) procedures. The SL had significantly more recurrent instability than the PL group (PL 9/99, 9.1%; SL 28/135, 20.7%; p=0.0158). There was no difference in overall reoperation rates (PL 13/99, 13.1%; SL 26/135, 19.3%; p=0.2140) or complication rates (PL 13/99, 13.3%; SL 20/135, 14.8%; p=0.9101). The rate of recurrent instability following the Latarjet procedure in an active, high-risk population 15.8%. Primary Latarjet was found to have lower rates of recurrence when compared to salvage Latarjet procedures (9.1% vs 20.7%). Level III Evidence.