ISSN: 2577-297X
Authors: Ilhame Khmilech , Mohamed Hammouti , Walid Bouziane , Mohammed Sadougui and Abdelkrim Daoudi
Introduction: Anterior shoulder instability with significant glenoid bone loss is a debilitating condition for heavy manual workers. While the Latarjet procedure is recognized for its mechanical robustness, data regarding the specific Return to Work (RTW) for this high-demand population remain limited.
Hypothesis: The Latarjet procedure allows for a reliable return to heavy manual activity despite extreme physical constraints.
Materials and Methods: We retrospectively reviewed 43 consecutive active manual workers (mean age 32.5 years; range 25–45) treated with open Latarjet for recurrent anterior instability and >20% glenoid bone defect. The cohort included masons, plumbers, electricians, plasterers, and facade workers. Evaluation at a mean follow-up of 3.7 years included range of motion and four scores: Constant-Murley (CMS), QuickDASH, WOSI, and SIRSI.
Results: The procedure achieved a 93% stability rate, with 3 cases of recurrence (7%). While the majority of patients resumed work between the 3rd and 6th postoperative months, 19 patients (44.2%) required professional retraining. We noticed the primary causes for professional failure were persistent apprehension associated with external rotation limitation (n=8), residual pain (n=6), recurrence (n=3), and coracoid graft resorption (n=2). Statistical analysis indicated that these professional failures were associated with a SIRSI score < 56 (p<0.0001) and an external rotation (ER1) loss ≥15∘ (p=0.04).
Discussion: This rate of professional retraining (44.2%) highlights that occupational success is not solely dependent on mechanical stability. The association between SIRSI scores below 56 and failure implies that psychological readiness may act as a factor for returning to high-intensity labor environments. Furthermore, the correlation between a moderate external rotation deficit (≥15∘) and professional failure suggests that for manual trades involving overhead lifting or heavy pivot gestures, preserving functional mobility is as critical as anatomical reconstruction.
Conclusion: The Latarjet procedure provides a stable shoulder for manual workers. However, surgical success does not guarantee a full professional return; psychological readiness and the restoration of functional rotation appear to be predictors of a successful professional outcome.
Level of Evidence: IV (Retrospective Cohort Study)
Keywords: Latarjet; Shoulder; Instability; Manual Worker; Return to Work; SIRSI