Return to active duty following Bankart repair and Latarjet procedure for traumatic anterior shoulder dislocation in a military population: a single-center retrospective cohort study

IF 2.9 2区医学 Q1 ORTHOPEDICS Journal of Shoulder and Elbow Surgery Pub Date : 2025-09-01 Epub Date: 2025-02-10 DOI:10.1016/j.jse.2024.12.039

Sanne H. van Spanning MD , Lukas P.E. Verweij MD , Theodore P. van Iersel MD , Michel P.J. van den Bekerom MD, PhD , Derek F.P. van Deurzen MD, PhD , P. Paul F.M. Kuijer PhD , Sebastiaan Floor MD

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Abstract

Background

Given that shoulder instability mostly affects young patients, it is likely that return to active duty (RTAD) is an important factor in the military population. However, knowledge on factors associated with failure to RTAD in this patient group following arthroscopic Bankart repair (ABR) and Latarjet is limited. The aims were to (1) assess RTAD rates following ABR and Latarjet, (2) determine prognostic factors that are associated with failure to RTAD, and (3) assess the degree of limitation in work performance due to shoulder complaints.

Materials and methods

A retrospective cohort study was conducted including consecutive patients who underwent ABR or open Latarjet procedure to treat shoulder instability due to traumatic anterior shoulder dislocation(s) between 2014 and 2020. Failure to RTAD rates following ABR and Latarjet procedures were assessed presymptomatically, at 6 months and at final follow-up. A multivariate logistic regression analysis was used to identify factors associated with failure to RTAD. Covariates were selected based on univariate analyses. A heatmap was created to display the extent of limitations during work.

Results

One hundred and seven patients in military service with an average follow-up of 63 ± 26 months were included. RTAD rates at final follow-up were 76% and 85% for ABR and Latarjet patients, respectively (P = .33). There were no factors associated with failure to RTAD at 6 months and final follow-up. The percentage of patients working above shoulder height that was very/extremely limited decreased from 20% to 4% (ABR) and 33% to 0% (Latarjet) preoperatively to final follow-up.

Conclusion

The RTAD rates at final follow-up were 76% for ABR and 85% for Latarjet (P = .33). No variables associated with failure to RTAD were found at 6 months and at final follow-up at 63 ± 26 months. The degree of limitation experienced during work decreased for both patient groups following surgery (16%-33% to 0%-4%), suggesting an overall improvement in work performance for both groups.

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军人创伤性肩前脱位Bankart修复和Latarjet手术后重返现役：一项单中心回顾性队列研究。

背景：考虑到肩部不稳定主要影响年轻患者，重返现役（RTAD）可能是军人人群中的一个重要因素。然而，对该患者组在关节镜Bankart修复（ABR）和Latarjet后RTAD失败相关因素的了解有限。目的：目的是(1)评估ABR和Latarjet后的RTAD率(2)确定与RTAD失败相关的预后因素(3)评估肩部不适对工作表现的限制程度。材料和方法：一项回顾性队列研究，包括2014年至2020年间接受ABR或开放Latarjet手术治疗外伤性肩关节前脱位引起的肩关节不稳的连续患者。在症状前、6个月和最后随访时评估ABR和Latarjet手术后RTAD失败率。多变量逻辑回归分析用于确定与RTAD失败相关的因素。根据单因素分析选择协变量。制作了一张热图，以显示工作期间的限制程度。结果：共纳入107例现役军人，平均随访63±26个月。ABR和Latarjet患者最终随访时RTAD率分别为76%和85% （p=0.33）。在6个月和最后随访时，没有与RTAD失败相关的因素。从术前到最终随访，工作高度在肩高以上的患者比例从20%降至4% (ABR)，从33%降至0% （Latarjet）。结论：ABR组和Latarjet组的复职率分别为76%和85% （p = 0.33）。在6个月和最终随访（63±26个月）时，没有发现与RTAD失败相关的变量。手术后两组患者在工作中受到的限制程度均有所下降（16-33%至0-4%），表明两组患者的工作表现均有整体改善。

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.