title: Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up.
abstract: BACKGROUND
  Anterior instability in rugby players is characterized by the common finding of a bony lesion, which has been identified as a potential cause of recurrence after soft-tissue reconstruction. The Latarjet-Patte procedure is effective in the treatment of recurrent anterior instability in collision sports such as rugby union.
  
  
  METHODS
  We retrospectively assessed 34 rugby players (37 shoulders) stabilized with the Latarjet-Patte procedure. The mean follow-up was 12 years. All patients underwent clinical and radiographic assessment preoperatively and at final follow-up. Functional evaluation was performed with the Walch-Duplay and Rowe scores. A visual analog scale score for the evaluation of pain and the subjective shoulder value were recorded. In addition, all patients completed a questionnaire regarding the return to playing rugby.
  
  
  RESULTS
  No recurrence of either dislocation or subluxation occurred. Persistent apprehension on clinical examination was present in 5 patients (14%). A bony lesion of the glenoid was present in 73% and a Hill-Sachs lesion in 68%. Sixty-five percent of the patients returned to playing rugby; only 1 patient did not return to playing rugby because of his shoulder. The mean Walch-Duplay and Rowe scores were 86 and 93 points, respectively. The mean subjective shoulder value was 90%. Radiographic healing of the bone block was observed in 89% of cases. At final follow-up, 11 patients (30%) had minor arthritic changes, with no cases of moderate or severe arthritis.
  
  
  CONCLUSIONS
  The Latarjet-Patte procedure provides a reliable method for stabilizing the shoulder, resulting in a return to playing rugby in a high number of cases without increasing the risk of long-term arthritic degradation.
authors.affiliation: Centre Orthopédique Santy, Lyon, France. neyton.lionel@orange.fr
authors.forename: Lionel
authors.initials: L
authors.lastname: Neyton
authors.forename: Allan
authors.initials: A
authors.lastname: Young
authors.forename: Bérangère
authors.initials: B
authors.lastname: Dawidziak
authors.forename: Enrico
authors.initials: E
authors.lastname: Visona
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Hager
authors.forename: Yann
authors.initials: Y
authors.lastname: Fournier
authors.forename: Gilles
authors.initials: G
authors.lastname: Walch
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005538:Football / Q000293:injuries*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011859:Radiography; D012008:Recurrence; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult