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.

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.

Purpose: 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 six 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-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 (p=0.33). 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 were very/extremely limited decreased from 20% to 4% (ABR) and 33% to 0% (Latarjet) preoperatively to final follow-up.

Conclusion: The return to active duty rates at final follow-up were 76% for ABR and 85% for Latarjet (p = 0.33). 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.