Diagnosis of shoulder apprehensions two years after latarjet procedure: a retrospective observational study

Abstract

Introduction: Despite high stabilization rates after Latarjet procedure, persistent apprehension during shoulder use remains a concern. Methods: Retrospective observational single-center study in patients who underwent Latarjet procedure for shoulder dislocation. The primary objective was two-year post-operative overall apprehension rate (‘In general, do you experience any apprehension when using your shoulder?’), with or without capsular repair. The secondary objective was to assess whether overall apprehension was related to functional scores (Rowe, Walch-Duplay and SANE). Results: Fifty-three patients were screened (mean age, 30.1 years; capsular repair, 83.0%) and 44 were analyzed for primary and secondary objectives. No patient experienced shoulder dislocation recurrence. Overall apprehension for using shoulder was nevertheless high and comparable with or without capsular repair (57.1% vs. 50.0%, respectively; p = 1.00). According to Stability domains of Walch-Duplay and Rowe scores, 20.5% and 29.5% of patients had shoulder apprehension, respectively. Specificity of Rowe, Walch-Duplay and SANE scores to identify overall apprehension was 94.4% (95% CI, 83.9–100), 94.7% (84.7–100), 77.8% (58.6–97.0) and sensitivity was 47.8% (95% CI, 27.4–68.2), 47.8% (27.4–68.2), 72.7% (54.1–91.3), respectively. Conclusion: Half of patients reported persistent shoulder apprehension after Latarjet procedure regardless of capsular repair. Rowe and Walch-Duplay scores had high specificity to identify shoulder apprehension. However, their low sensitivity may underestimate persistent shoulder apprehension despite obvious shoulder stability.