Return to Sport After Coracoid Transfer in Athletes With Anterior Shoulder Instability: A Systematic Review

Context: Recurrent shoulder instability in young athletes can lead to a spectrum of soft tissue and bony lesions that can be bothersome and/or disabling. Coracoid transfer is a treatment option for athletes with recurrent instability. Objective: To report the rate of return to sport for athletes after coracoid transfer. Data Sources: An electronic search of the literature was performed using the PubMed (MEDLINE) and Cochrane Databases (1966-2018). Study Selection: Studies were included if they evaluated return to sport after treatment with coracoid transfer at a minimum 1-year follow-up. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data were extracted by 2 authors and included study design, level of evidence, patient demographics (number, age, sex), procedure performed, duration of clinical follow-up, rate of return to sport, patient-reported outcome measures, reoperations, and complications. Results: Fourteen studies met the inclusion criteria. The rate of return to sport at any level ranged from 80% to 100% in all but 1 study (38%), and the rate of return to the previous level of play ranged from 56% to 95% in all but 1 study (16%). Patients returned to sport at an average of 3.2 to 8.1 months. The average patient-reported outcome scores ranged from 78% to 94% (Rowe), 223.6 to 534.3 (Western Ontario Shoulder Instability Index), and 75% to 90% (subjective shoulder value). The rate of postoperative dislocation ranged from 0% to 14%, and the reoperation rate ranged from 1.4% to 13%. Conclusion: There was a high early rate of return to sport in patients who underwent coracoid transfer for anterior shoulder instability, although patients did not reliably return to the same level of play. The procedure had very favorable outcomes for treatment of instability, with low rates of recurrent dislocation and reoperation.

[1]  M. Ranalletta,et al.  Modified Latarjet Procedure Without Capsulolabral Repair for the Treatment of Failed Previous Operative Stabilizations in Athletes. , 2018, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[2]  K. Kaneko,et al.  Midterm Clinical Results in Rugby Players Treated With the Bristow Procedure , 2018, The American journal of sports medicine.

[3]  C. Lim,et al.  Return to sports after the latarjet procedure: high return level of non-collision athletes , 2018, Knee Surgery, Sports Traumatology, Arthroscopy.

[4]  M. Ranalletta,et al.  Modified Latarjet Without Capsulolabral Repair in Rugby Players With Recurrent Anterior Glenohumeral Instability and Significant Glenoid Bone Loss , 2018, The American journal of sports medicine.

[5]  Alan L. Zhang,et al.  Return to Play Following Shoulder Stabilization: A Systematic Review and Meta-analysis , 2017, Orthopaedic journal of sports medicine.

[6]  R. Rossi,et al.  Arthroscopic Bankart Repair Versus Open Bristow-Latarjet for Shoulder Instability , 2016, The American journal of sports medicine.

[7]  S. Klouche,et al.  Outpatient Latarjet surgery for gleno-humeral instability: Prospective comparative assessment of feasibility and safety. , 2016, Orthopaedics & traumatology, surgery & research : OTSR.

[8]  P. Hardy,et al.  Anterior shoulder stabilization by Bristow–Latarjet procedure in athletes: return-to-sport and functional outcomes at minimum 2-year follow-up , 2016, European Journal of Orthopaedic Surgery & Traumatology.

[9]  J. D. de Beer,et al.  Evaluation of functional outcomes and complications following modified Latarjet reconstruction in athletes with anterior shoulder instability , 2015, Shoulder & elbow.

[10]  P. Boileau,et al.  Arthroscopic Bristow-Latarjet Combined With Bankart Repair Restores Shoulder Stability in Patients With Glenoid Bone Loss , 2014, Clinical orthopaedics and related research.

[11]  P. Boileau,et al.  The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair , 2014, Clinical orthopaedics and related research.

[12]  L. Higgins,et al.  Clinical Outcomes Following the Latarjet Procedure in Contact and Collision Athletes , 2014, The Journal of bone and joint surgery. American volume.

[13]  K. Briggs,et al.  Patient expectations before arthroscopic shoulder surgery: correlation with patients' reasons for seeking treatment. , 2013, Journal of shoulder and elbow surgery.

[14]  N. White,et al.  Traumatic anterior shoulder instability in the athlete , 2013, Scandinavian journal of medicine & science in sports.

[15]  G. Walch,et al.  Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up. , 2012, Journal of shoulder and elbow surgery.

[16]  M. Griesser,et al.  Prediction of coracoid thickness using a glenoid width-based model: implications for bone reconstruction procedures in chronic anterior shoulder instability. , 2012, Journal of shoulder and elbow surgery.

[17]  J. Agel,et al.  Incidence of Glenohumeral Instability in Collegiate Athletics , 2009, The American journal of sports medicine.

[18]  F. Balg,et al.  The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. , 2007, The Journal of bone and joint surgery. British volume.

[19]  C. Robinson,et al.  Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. , 2006, The Journal of bone and joint surgery. American volume.

[20]  S. Nakagawa,et al.  Bankart Procedure Augmented by Coracoid Transfer for Contact Athletes with Traumatic Anterior Shoulder Instability , 1999, The American journal of sports medicine.

[21]  S. Roche,et al.  The modified Latarjet procedure in female patients: clinical outcomes and complications. , 2018, Journal of shoulder and elbow surgery.