Okay, thank you for the opportunity to present our work regarding sling mobilization after open Latarje. So there are no relevant disclosures to this talk. Traumatic anterior shoulder instability commonly affects young to middle-aged athletes and the Latarje procedure was shown to have a low recurrence rate in this specific population. It further enables an early return to sport, a mean time of five months, as revealed by a recent systematic review. What remains unknown is the time necessary for immobilization after surgery, with typically two to four weeks reported in the literature. This is, however, driven by surgeon preference rather than any scientific rationale. We know that there is a negative effect of immobilization and the benefit of early passive assisted motion after shoulder surgery, but we do not know if there is a protective effect of immobilization with a sling on complication rates, especially regarding recurrent dislocation, graft union, fracture, or screw pull out. Why does it matter? So we operate on young patients. Most of them are active, so you want to avoid stiffness, especially in external rotation. You want to avoid muscular atrophy and you want to bring them back to daily activities, including driving as early as possible. Further, if you treat athletes, they want or need to stay active and they will do it with or without your formal consent. So the aim of our research was to evaluate the impact of immobilization on short-term clinical outcomes after open latergy, and we hypothesized that immediate self-rehabilitation without a sling would result in improved functional outcomes at six months follow-up compared to patients wearing a sling for three weeks. This was a randomized controlled trial, so both groups had an open latergy with two screws and both had immediate passive assisted self-rehabilitation according to the Lyotard protocol. If you want further details, the study protocol has been published in trials. Inclusion criteria were glenoid bone defects of more than 20%, contact athletes, failed bankart, repairs, open or arthroscopic, and age frame between 16 and 65 years of age. Exclusion criteria were subscap tears, preoperative stiffness, dislocation, arthropathy, polytrauma patient, no or suspected noncompliance due to drug or alcohol abuse. Primary outcome was six months functional outcome as assessed by the disease-specific row score. Secondary outcomes were sane instability score, VIS pain score, and we also evaluated the radiological outcome using a CT scan at six months follow-up using the Hoveldius criteria for graft union. So the randomization process worked well with no significant difference between groups regarding age, gender, and preoperative row or sane instability score. The results of the trial showed no significant difference regarding postoperative row score at six months, VIS pain score, or sane instability score. Regarding the radiological outcome, we had one case of fibrous nonunion in the sling group and two cases in the no sling group. Finally, we had just one screw pull out and this happened actually in the sling group. So in conclusion, both treatment groups resulted in excellent early functional outcomes. We had a low 5% rate of fibrous graft nonunion at six months, and we are currently following up on this patient with CT scans at one year to see if they progress towards union. So the absence of postoperative sling normalization did not increase the complication rates in our study. We therefore modified our practice and stopped using slings after open lattage surgery. Thank you. Excellent. Great. Thank you very much.

randomized controlled trial

immobilization

sling

immediate self-rehabilitation

open Latarje surgery