Are the dominant-nondominant functional differences at 4.5 months after open Latarjet procedure better predictors for successful return to sport at 1 year postoperatively than the operated-nonoperated differences?

Abstract

Background: There is no evidence on which functional levels have to be recovered to return to the preinjury sport at the preinjury level, that is, successful RTS, after an open Latarjet procedure. Therefore, this study aimed to identify whether RTS criteria assessed at 4.5 months postoperatively predict successful RTS at 1 year after the open Latarjet procedure.

Methods: All patients who underwent an open Latarjet procedure between August 2018 and July 2021 were eligible. At 4.5 months postoperatively, patients completed the Shoulder Instability-Return to Sport after Injury questionnaire and performed unilaterally with each side maximal isometric strength in glenohumeral internal and external rotation, Upper-Quarter Y Balance Test, Unilateral Seated Shot-Put Test, and modified Closed Kinetic Chain Upper Extremity Stability Test. They answered RTS inquiry at 12 months postoperatively. Logistic regressions were applied to assess the ability of parameters based on operated-nonoperated or dominant-nondominant ratios to predict successful RTS.

Results: Among 126 eligible patients, 110 answered the RTS inquiry; 21 patients were excluded, 49 were included in the successful RTS group, and 40 in the unsuccessful RTS group. No parameters based on the operated-nonoperated ratios were prognostic factors for successful RTS. Despite a low precision of the model (area under the receiver operating characteristic curve = 0.64), dominant-nondominant ratios in internal rotation strength (odds ratio [OR] = 0.98, P = .02), balance between external and internal rotation strength at the operated shoulder (OR = 1.03, P = .02), and muscular endurance ability (OR = 1.03, P = .04) were found to be prognostic factors for successful RTS.

Conclusion: The findings challenge the ability of criteria expressing operated shoulder functions with reference to those of the contralateral one in predicting a successful RTS. They suggest that when assessed 4.5 months postoperatively, the balance of function between dominant and nondominant shoulders in reference to those of healthy athletes would be better predictors of returning to preinjury sport at the preinjury level. This study highlights that clinicians and sport supervisors may place particular care on the recovery of dominant-nondominant balance in maximal internal rotation strength and in upper extremities strength endurance to enhance the likelihood of returning to sport successfully for their athletes who underwent anterior shoulder stabilization surgery by an open Latarjet procedure.