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Objectives and questions: Sex-based differences after the Latarjet procedure are poorly defined because women are underrepresented and baseline characteristics differ across cohorts. This study compared outcomes and postoperative morbidity between women and men after primary Latarjet stabilization using propensity score matching.

Material and methods: This retrospective bicenter cohort included patients undergoing primary Latarjet stabilization with ≥12 months follow-up (men 21.8 ± 14.6 months; women, 23.0 ± 9.5 months) using a standardized technique. Women were matched 1:1 to men by nearest-neighbor propensity score matching (no replacement) for age, traumatic onset, generalized ligamentous laxity, number of preoperative dislocations, and sport level. The primary outcome was the postoperative Rowe score. Secondary outcomes were Subjective Shoulder Value (SSV), return to sport, return to sport at the preinjury level, postoperative range of motion, clinical signs of instability, and complications. Paired statistical analyses were applied.

Results: Twenty-six women were matched to 26 men (minimum follow-up 12 months). Outcomes were comparable: Rowe 88.5 ± 9.4 vs 92.7 ± 12.4 (p = 0.11) and SSV 87.3 ± 11.1% vs 89.8 ± 14.3% (p = 0.12). Return to sport was achieved by 85% of women and 96% of men (p = 0.38); return to sport at the same preinjury level by 62% and 69%, respectively (p = 0.18). Clinical signs of postoperative instability occurred more often in women (4 vs. 1) without statistical significance. Overall complication rates were low and comparable, but patterns differed: postoperative capsulitis predominated in women (n=3), whereas implant- or bone block-related complications occurred only in men (n=2).

Discussion and conclusions: Functional outcomes and return to sport were equivalent between women and men after primary Latarjet stabilization; however, sex-specific differences in complication patterns were observed.