title: Risk of arthropathy after the Bristow-Latarjet repair: a radiologic and clinical thirty-three to thirty-five years of follow-up of thirty-one shoulders.
abstract: BACKGROUND
  Transfer of the coracoid (Bristow-Latarjet [B-L]) is used to stabilize anterior shoulder instability. We report the long-term results of our first 31 operations with this method.
  
  
  METHODS
  Thirty-six patients (mean age, 26.7 years) had a B-L repair from 1977 to 1979. Five patients died, and during 2012 to 2013, the remaining 31 shoulders had a follow-up with questionnaire, physical examination, Western Ontario Shoulder Instability Index, Subjective Shoulder Value, Subjective Assessment of Shoulder Function, subjective assessment of loss of motion, and radiologic imaging.
  
  
  RESULTS
  One patient required revision surgery because of recurrence and another because of repeat dislocation. Six patients reported subluxations. Eighteen patients (58%) were very satisfied, and 13 (42%) were satisfied. The mean Western Ontario Shoulder Instability Index score (100 possible) was 85, and the median score was 93. According to Samilson-Prieto classification of arthropathy of the shoulder, 39% were classified as normal, 27% as mild, 23% as moderate, and 11% as severe. The classification of arthropathy varied with observers and radiologic views. Age younger than 22 years at the primary dislocation meant less arthropathy at follow-up (P = .045).
  
  
  CONCLUSIONS
  The degree of arthropathy 33 to 35 years after the B-L repair seems to follow the natural history of shoulder dislocation with respect to arthropathic joint degeneration. Postoperative restriction of external rotation does not increase later arthropathy.
authors.affiliation: Orthopaedic Department, Frölunda Specialist Hospital, Gothenburg, Sweden. Electronic address: vladlife@yahoo.com.
authors.forename: Vladislavs
authors.initials: V
authors.lastname: Gordins
authors.affiliation: Orthopaedic Department, Gävle Hospital, Gävle, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Hovelius
authors.affiliation: Orthopaedic Department, Gävle Hospital, Gävle, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Sandström
authors.affiliation: Orthopaedic Department, Elisabeth Hospital, Uppsala, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Rahme
authors.affiliation: Orthopaedic Department, Umeå University Hospital, Umeå, Sweden.
authors.forename: Ulrica
authors.initials: U
authors.lastname: Bergström
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D007593:Joint Instability / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D017060:Patient Satisfaction; D011859:Radiography; D012008:Recurrence; D012307:Risk Factors; D012783:Shoulder Dislocation / Q000150:complications / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Bristow-Latarjet repair; Risk of arthropathy in the shoulder; Samilson-Prieto classification; WOSI score; anterior dislocation of the shoulder; anterior instability