Outcomes of Arthroscopic Latarjet Procedure for Anterior Glenohumeral Instability in Patients With Epilepsy: A Case-Control Study

Background: Unacceptably high rates of redislocation, reoperation, osteoarthritis, and coracoid nonunion have been reported in patients with a seizure disorder after surgery for shoulder instabilitiy. Purpose: To evaluate the objective and subjective functional and radiologic results of the arthroscopic Latarjet procedure for anterior shoulder instability in patients with epilepsy and compare them with the results of patients without epilepsy. Study design: Cohort study; Level of evidence, 3. Methods: A retrospective and comparative case-control analysis of patients operated for shoulder instability with arthroscopic Latarjet was conducted. Nineteen patients (21 unstable shoulders) with a seizure disorder (epilepsy group) were matched with 21 patients without a history of seizure (control group). Demographics, surgical indications, and imaging data were collected. Clinical outcomes at a minimum 2 years of follow-up (range, 2-9 years) postoperatively included Rowe score, Western Ontario Shoulder Instability Index (WOSI), Constant-Murley Shoulder Outcome (CMSO) score, and Single Assessment Numeric Evaluation (SANE). The incidence of complications, recurrent instability, redislocation, revision surgery, repeated seizure(s), and presence of osteoarthritis, coracoid nonunion, and osteolysis were also examined. Results: After a mean follow-up of 4.5 years, no significant differences in functional results were found between patients with and without epilepsy on the average Rowe ( P = .917), WOSI ( P = .621), CMSO ( P = .600), and SANE ( P = .859) scores. A total of 5 patients (7 shoulders) continued to have seizures postoperatively, but no seizure-related glenohumeral instability was documented. One dislocation and 1 subluxation were documented while participating in sports in each study group, comprising a recurrence rate of 9.5%, but no significant differences were found at comparison ( P = .605). A bone defect did not influence the results, as no significant difference was found between the 2 groups. Osteoarthritic changes of the glenohumeral joint were observed in 5 shoulders (23.8%) in the epilepsy group and in 3 (14.3%) in the control group ( P = .451). No case of coracoid nonunion or osteolysis was recorded. There was no statistically significant difference in postoperative athletic activity ( P = .660). However, patients with epilepsy had significantly lower pre- and postoperative sports participation ( P < .001). Conclusion: Arthroscopic Latarjet stabilization can lead to improved functional and subjective outcomes and should be considered in patients with epilepsy with recurrent anterior glenohumeral instability. These results can be achieved regardless of the presence of bone defect and the postoperative control of seizures and are similar to those in patients without epilepsy.

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ARTHROSCOPIC LATARJET TECHNIQUE COMBINED WITH ENDOBUTTONS: FUNCTIONAL OUTCOMES IN 26 CASES

Acta Ortopédica Brasileira ◽

10.1590/1413-785220182605208650 ◽

2018 ◽

Vol 26 (5) ◽

pp. 328-331 ◽

Cited By ~ 2

Author(s):

Alexandre Tadeu do Nascimento ◽

Gustavo Kogake Claudio ◽

Pedro Bellei Rocha ◽

Juan Pablo Zumárraga ◽

Olavo Pires de Camargo

Keyword(s):

Shoulder Instability ◽

Functional Outcomes ◽

Short Form ◽

Case Series ◽

Anterior Shoulder Instability ◽

Latarjet Procedure ◽

Glenohumeral Instability ◽

Duration Of Symptoms ◽

Arthroscopic Latarjet ◽

Arthroscopic Latarjet Procedure

ABSTRACT Objective: The cause of anterior shoulder instability is not fully understood and surgical management remains controversial. The objective of this study was to evaluate the results of patients undergoing arthroscopic Latarjet procedure with endobuttons. Methods: A retrospective study of 26 patients undergoing arthroscopic Latarjet procedure with endobuttons to treat anterior shoulder instability. Patients with previous glenohumeral instability, failure of Bankart procedure or Instability Severity Index Score (ISIS) greater than or equal to 6, were included. Patients were assessed by: DASH, UCLA, Rowe, Visual Analog Scale (VAS) of pain and Short-Form 36 (SF36) scores. Correct position and consolidation of the graft were evaluated. Results: Mean age was 31.5 years (16 to 46). Preoperative duration of symptoms was 1.7 years (1 month to 10 years). Mean follow-up was 14.3 (6 to 24) months. Mean postoperative scores were: 10 points in DASH; 1.6 in VAS, where 23 (88%) patients experienced mild pain and 3 (12%) moderate pain; 89 in Rowe; 32 in UCLA and 78 in SF-36. Positioning of the graft was correct in 25 (96%) cases, and was consolidated in 23 (88%). We had two cases of graft fracture (7%) and postoperative migration (7%). Conclusion: Surgical treatment using arthroscopic Latarjet with endobuttons is safe and effective, producing good functional outcomes in patients. Level of Evidence IV, Case Series.

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Modified Arthroscopic Latarjet Procedure: Suture-button Fixation will not Cause Obvious Increasement of Superior Instability at 5-Year Follow-up

10.21203/rs.3.rs-105908/v1 ◽

2020 ◽

Author(s):

Daqiang Liang ◽

Haifeng Liu ◽

Xinzhi Liang ◽

Qihuang Qin ◽

Lujue Long ◽

...

Keyword(s):

Control Group ◽

Latarjet Procedure ◽

Glenoid Defect ◽

Coracoacromial Ligament ◽

Intact Side ◽

Arthroscopic Latarjet ◽

Arthroscopic Latarjet Procedure ◽

Preoperative Ct ◽

Shoulder Scores

Abstract Background: Whether coracoacromial ligament (CAL) release during Latarjet procedure will increase superior instability of shoulder joint postoperatively remains controversial. This study aims to observe changes in the acromiaohumeral distance (AHD) of patients who underwent modified double-button Latarjet procedure and provide evidence to address the issue.Methods: A retrospective analysis was conducted among 155 patients who underwent modified double-button Latarjet procedure in our department from 2013 to 2015. Preoperative CT scan of bilateral shoulders were used for glenoid defect evaluation. CT scans were performed immediately after operation (PO 0) and during the follow-up at 6, 36, and 60 months postoperatively (POM) to observe the healing and remodeling of the graft, and AHD was measured. The intact sides were set as control group. VAS and objective shoulder scores, including ASES, ROWE, and Walch-Duplay scores, were recorded at each time point.Results: A total of 104 cases who met the criteria completed follow up. The average follow-up time was 62.6 ± 2.4 months. Compared with preoperative conditions, the function scores of the shoulders were significantly improved at the last follow-up. There were no statistical differences of the AHD values between bilateral shoulders preoperatively. The AHD values at PO 0 and POM 6 were significantly higher than those of intact side (p < 0.05). The AHD values at POM 36 and 60 were slightly higher than those of intact side and the differences were statistically significant (p < 0.05).Conclusions: The modified double-button Latarjet procedure not only offers satisfactory therapeutic effect but also will not cause obvious superior instability at the 5-year follow-up.

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Modified Arthroscopic Latarjet Procedure With Coracoid Exteriorization for Treatment of Anterior Glenohumeral Instability

Arthroscopy Techniques ◽

10.1016/j.eats.2013.05.003 ◽

2013 ◽

Vol 2 (4) ◽

pp. e361-e365 ◽

Cited By ~ 3

Author(s):

Juha O. Ranne ◽

Terho U. Kainonen ◽

Janne T. Lehtinen ◽

Olli J. Heinonen

Keyword(s):

Latarjet Procedure ◽

Glenohumeral Instability ◽

Arthroscopic Latarjet ◽

Arthroscopic Latarjet Procedure ◽

Anterior Glenohumeral Instability

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Does the Arthroscopic Latarjet Procedure Effectively Correct “Off-Track” Hill-Sachs Lesions?

The American Journal of Sports Medicine ◽

10.1177/0363546517728717 ◽

2017 ◽

Vol 46 (1) ◽

pp. 72-78 ◽

Cited By ~ 6

Author(s):

Johannes E. Plath ◽

Daniel J.H. Henderson ◽

Julien Coquay ◽

Klaus Dück ◽

David Haeni ◽

...

Keyword(s):

Case Series ◽

3D Ct ◽

Latarjet Procedure ◽

Glenohumeral Instability ◽

Level Of Evidence ◽

Arthroscopic Latarjet ◽

Glenoid Track ◽

Arthroscopic Latarjet Procedure ◽

The Mean

Background: The glenoid track concept describes the dynamic interaction of bipolar bone loss in anterior glenohumeral instability. Initial studies have successfully demonstrated this concept’s application in clinical populations. In clinical practice, the Latarjet procedure is commonly the preferred treatment in addressing “off-track” Hill-Sachs lesions. The effectiveness of this procedure in restoring such lesions to an “on-track” state, however, has not yet been evaluated or described in the literature. Hypothesis: The Latarjet procedure would transform “off-track” Hill-Sachs lesions to “on-track” lesions. Lesions would remain “on-track” during follow-up, despite glenoid remodeling. Study Design: Case series; Level of evidence, 4. Methods: Patients with “off-track” Hill-Sachs lesions treated with the arthroscopic Latarjet procedure between March 2013 and May 2014 were included. Glenoid track and coracoid graft contact surface area measurements using 3-dimensional computed tomography (3D-CT) were performed preoperatively and at 6-week, 6-month, and at least 12-month (final) follow-up. The mean final follow-up was 23 months. The glenoid diameter, as a percentage of the native glenoid, was also calculated from this imaging. Results: Twenty-six patients met the inclusion criteria. 3D-CT scans were available for all patients preoperatively and postoperatively, with 21 patients (81%) undergoing 6-month follow-up CT and 19 patients (73%) undergoing final follow-up CT. Hill-Sachs lesions remained “on-track” at all follow-up time points. The mean glenoid diameter changed significantly from 84.6% preoperatively to 122.8% at 6 weeks ( P < .001) and from 120.5% at 6 months to 113.9% at final follow-up ( P = .005). This was also reflected in significant remodeling seen in the coracoid graft articular contact area (6 weeks to 6 months, P = .024; 6 months to final follow-up, P = .002). This persisting glenoid arc enlargement at final follow-up avoided “off-track” Hill-Sachs lesions in 6 of 19 patients (32%), which would otherwise have occurred had the coracoid graft remodeled to native glenoid dimensions. Conclusion: The Latarjet procedure provides an effective treatment for “off-track” engaging Hill-Sachs lesions, despite an evident glenoid remodeling process. At a mean of 23 months postoperatively, a mean persisting enlargement of the glenoid arc of 14% beyond native dimensions remained, avoiding a recurrent “off-track” lesion in 32% of patients, which would otherwise have occurred with complete remodeling.

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Early Follow‐Up of Arthroscopic Latarjet Procedure with Screw or Suture‐Button Fixation for Recurrent Anterior Shoulder Instability

Orthopaedic Surgery ◽

10.1111/os.12781 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1350-1361

Author(s):

Yi Wang ◽

Zhi‐you Zhou ◽

Yong‐jin Zhang ◽

Chong‐ru He ◽

Chen‐chen Xue ◽

...

Keyword(s):

Shoulder Instability ◽

Anterior Shoulder Instability ◽

Latarjet Procedure ◽

Suture Button ◽

Arthroscopic Latarjet ◽

Arthroscopic Latarjet Procedure ◽

Recurrent Anterior Shoulder Instability

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Open Versus Arthroscopic Latarjet Procedure for the Treatment of Chronic Anterior Glenohumeral Instability With Glenoid Bone Loss

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2019.09.042 ◽

2020 ◽

Vol 36 (4) ◽

pp. 940-949 ◽

Cited By ~ 2

Author(s):

Jotyar Ali ◽

Burak Altintas ◽

Anil Pulatkan ◽

Robert E. Boykin ◽

Direnc Ozlem Aksoy ◽

...

Keyword(s):

Bone Loss ◽

Glenoid Bone Loss ◽

Latarjet Procedure ◽

Glenohumeral Instability ◽

Arthroscopic Latarjet ◽

Arthroscopic Latarjet Procedure ◽

Open Versus ◽

Anterior Glenohumeral Instability

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Are the Classic and the Congruent Arc Latarjet Procedures Equally Effective for the Treatment of Recurrent Shoulder Instability in Athletes?

The American Journal of Sports Medicine ◽

10.1177/0363546520928343 ◽

2020 ◽

Vol 48 (9) ◽

pp. 2081-2089

Author(s):

Luciano A. Rossi ◽

Ignacio Tanoira ◽

Tomás Gorodischer ◽

Ignacio Pasqualini ◽

Domingo Luis Muscolo ◽

...

Keyword(s):

Functional Outcomes ◽

Bone Block ◽

Return To Sports ◽

Glenohumeral Instability ◽

Level Of Evidence ◽

Significant Difference ◽

Functional Scores ◽

The Mean ◽

Anterior Glenohumeral Instability

Background: There is a lack of evidence in the literature comparing outcomes between the classic and the congruent arc Latarjet procedures in athletes. Purpose: To compare return to sports, functional outcomes, and complications between the classic and the congruent arc Latarjet procedures in athletes with recurrent glenohumeral instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2009 and June 2017, 145 athletes with recurrent anterior glenohumeral instability underwent surgery with the Latarjet as a primary procedure in our institution. The classic procedure was used in 66 patients, and the congruent arc method was used in 79 patients. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sports activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. Results: In the total population, the mean follow-up was 41.3 months (range, 24-90 months) and the mean age was 25.3 years (range, 18-45 years). In total, 90% of patients were able to return to sports; of these, 91% returned at their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistical improvement after operation ( P < .001). The Rowe score increased from a preoperative mean of 42.8 points to a postoperative mean of 95.2 points ( P < .01). Subjective pain during sports improved from 3.2 points preoperatively to 0.7 points at last follow-up ( P < .01). The ASOSS score improved significantly from a preoperative mean of 46.4 points to a postoperative mean of 88.4 points ( P < .01). No significant differences in shoulder ROM and functional scores were found between patients who received the classic vs congruent arc procedures. There were 5 recurrences (3.5%): 3 dislocations (2%) and 2 subluxations (1%). No significant difference in the recurrence rate was noted between groups. The bone block healed in 134 cases (92%). Conclusion: In athletes with recurrent anterior glenohumeral instability, the Latarjet procedure produced excellent functional outcomes. Most athletes returned to sports at their preinjury level, and the rate of recurrence was very low, regardless of whether the patients received surgery with the classic or congruent arc technique.

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