Ladermann et al identified risk factors for dislocation arthropathy of the shoulder following a Latarjet procedure. These can help to identify a patient who may benefit from more aggressive management or an alternative procedure. The authors are from Geneva University Hospitals in Switzerland.
Patient selection: shoulder dislocation treated with the Latarjet procedure
Outcome: degenerative arthropathy in the dislocated shoulder
Risk factors for dislocation arthropathy:
(1) age at surgery > 40 years (hazard ratio 2.2)
(2) lateral positioning of the coracoid process transfer in relation to the glenoid rim (hazard ratio 2.3)
(3) absence of hyperlaxity (2.5, hyperlaxity protective with hazard ratio 0.4)
|
Parameter
|
Finding
|
Points
|
|
age at surgery
|
<= 40 years of age
|
0
|
|
|
> 40 years of age
|
1
|
|
lateral coracoid transfer
|
no
|
0
|
|
|
yes
|
1
|
|
hyperlaxity
|
absent
|
1
|
|
|
present
|
0
|
where:
• Hyperlaxity was defined as external rotation > 90 degrees with elbow held at the side.
total number of risk factors =
= SUM(points for the 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The risk of dislocation arthropathy increases with the number of risk factors.
