The Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss

2020 ◽  
pp. 175857322094416
Author(s):  
Luciano A Rossi ◽  
Ignacio Tanoira ◽  
María G Bruchmann ◽  
Ignacio Pasqualini ◽  
Maximiliano Ranalletta
Keyword(s):  
Bone Loss ◽  
Scoring System ◽  
Functional Outcomes ◽  
Glenoid Bone Loss ◽  
Bone Block ◽  
Return To Sports ◽  
Latarjet Procedure ◽  
Competitive Athletes ◽  
The Mean

Purpose To analyze return to sports, functional outcomes, and complications following the Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss. Methods Between 2010 and 2017, 60 competitive athletes younger than 20 years old with a significant glenoid bone loss were operated with the Latarjet procedure. Return to sports, range of motion, and the Rowe and the Athletic Shoulder Outcome Scoring System score were used to assess functional outcomes. Complications and bone consolidation were also evaluated. Results The mean follow-up was 58 months and the mean age was 16.3 years. Overall, 93% were able to return to sports and 84% returned at the same level. The Rowe and Athletic Shoulder Outcome Scoring System scores showed statistical improvement after operation ( P <  .001). The total complication rate was 22% and the revision rate was 1.6%. The recurrence rate was 3.3%. The bone block healed in 93% of the cases. Conclusions In competitive athletes younger than 20 years old with a significant glenoid bone loss, the Latarjet procedure resulted in excellent functional outcomes, with most of the patients returning to sports and at the same level they had before injury with a low rate of recurrences. However, this procedure is associated with a significant rate of complications and should preferably be performed by experienced surgeons.

Modified Latarjet Without Capsulolabral Repair in Rugby Players With Recurrent Anterior Glenohumeral Instability and Significant Glenoid Bone Loss

2018 ◽  
Vol 46 (4) ◽  
pp. 795-800 ◽  
Author(s):  
Maximiliano Ranalletta ◽  
Luciano A. Rossi ◽  
Agustin Bertona ◽  
Ignacio Tanoira ◽  
Ignacio Alonso Hidalgo ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Functional Outcomes ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Instability ◽  
Bone Block ◽  
Latarjet Procedure ◽  
The Mean ◽  
Rugby Players ◽  
Recurrent Anterior Shoulder Instability

Background: The optimal management of recurrent anterior shoulder instability with significant glenoid bone loss in high-demand collision athletes remains a challenge. Purpose: To analyze the time to return to sport, clinical outcomes, and recurrences following a modified Latarjet procedure without capsulolabral repair in rugby players with recurrent anterior shoulder instability and significant glenoid bone loss. Study Design: Case series; Level of evidence, 4. Methods: Between June 2008 and June 2015, 50 competitive rugby players (practice >2 times per week and competition during weekends) with recurrent anterior shoulder instability underwent operation with the modified congruent arc Latarjet procedure without capsulolabral repair in our institution. Cases included 18 primary repairs and 32 revisions. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale for pain in sport activity (VAS), 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. The final analysis included 49 shoulders in 48 patients (31 revision cases). Results: The mean follow-up was 48 months (range, 24-108 months) and the mean age at the time of operation was 22.8 years (range, 17-35 years). Forty-five patients (93.7%) returned to playing rugby, all 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 statistically significant improvement after operation ( P < .001). The Rowe score increased from a mean of 39.5 points preoperatively to 94 points postoperatively ( P < .01). The VAS score decreased from 3.6 points preoperatively to 1.2 points postoperatively ( P < .01). The ASOSS score improved significantly from a mean of 44 points preoperatively to 89.5 points postoperatively ( P < .01). No recurrence of shoulder dislocation or subluxation was noted. The bone block healed in 43 shoulders (88%). Conclusion: In rugby players with recurrent anterior shoulder instability and significant glenoid bone loss, the modified Latarjet procedure without capsulolabral repair produced excellent functional outcomes, with most athletes returning to rugby at their preinjury level of play without recurrences.

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

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.

LATARJET PROCEDURE FOR RECURRENT SHOULDER ANTERIOR INSTABILITY WITH LESS THAN 25% GLENOID BONE LOSS- ITS FUNCTIONAL OUTCOME: A PROSPECTIVE STUDY

2021 ◽  
pp. 62-65
Author(s):  
Arun Kumar KV ◽  
Arun Kumar C ◽  
Venkatachalam K ◽  
Gussain Rahul Vijay ◽  
Ashwin V Y ◽  
...  
Keyword(s):  
Bone Loss ◽  
Functional Outcome ◽  
Shoulder Dislocation ◽  
Scoring System ◽  
Index Score ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Dislocation ◽  
Latarjet Procedure ◽  
Shoulder Score

Background: Latarjet procedure for a recurrent anterior shoulder dislocation with more than 25% of bone loss is a standard treatment with good functional outcome. In glenoid bone loss < than25%, there is no concurrence in the surgery of choice between Bankart repair, Remplissage procedure and Latarjet procedure. This study is aimed to study the functional outcome following Latarjet procedure in recurrent shoulder instability in patients with < than 25% glenoid bone loss and also to assess the instability symptoms and complications following this procedure. Methods: It is a Clinical, Prospective and Observational study on thirty patients with recurrent anterior dislocation of shoulder, with less than 25% glenoid bone loss treated with Open Latarjet Procedure, at Chettinad Hospital and Research Institute, Kelambakkam, done between Jan 2017 to Dec 2020, with a minimum follow-up of atleast 1year duration. Patients were post-operatively assessed functionally using Constant shoulder score, Rowe scoring system and the Walch- Duplay index score. Clinical instability was also assessed using the Anterior Apprehension and Anterior Drawer Test. Results: In our study with thirty patients, who underwent Latarjet procedure, Functional outcome of the patients were assessed using the Constant shoulder score, Rowe scoring system and the Walch- Duplay index score. The combined average percentage of Score of Scores of the three scoring systems were 74.46% had Excellent results, 14.42% had Good and 11.12% of patients had Average or Fair results. None of the patients had any instability symptoms post-operatively at the 1year post-op follow-up. Four patients had supercial Surgical Site Infections and 2 patients had developed mild to moderate shoulder stiffness. Conclusion: The Latarjet gives conrmationally Excellent to Good functional outcome and aid in the early return to activities of daily living and a fewer failure rate. In patients with Recurrent Anterior Shoulder Dislocation, with even less than 25% Glenoid bone loss, it may be pertinent to primarily consider the osseous option of a coracoid transfer (Latarjet) rather than opt for simpler Open Bankart, Arthroscopic Bankart or an Arthroscopic Remplissage procedure alone. Thus, as a yardstick the bone loss concept, either on the Glenoidal or on the Humeral aspect, alone, need to be the deciding factor. The fact remains that in the athletic or otherwise Recurrent Anterior Shoulder Dislocators, there is also a concomitant humeral component, apart from the apparent and demonstrable Glenoid defect with the “Circle concept”.

scholarly journals Comparison Between Modified Latarjet Performed as a Primary or Revision Procedure in Competitive Athletes: A Comparative Study of 100 Patients With a Minimum 2-Year Follow-up

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881723 ◽  
Author(s):  
Luciano A. Rossi ◽  
Agustin Bertona ◽  
Ignacio Tanoira ◽  
Gastón D. Maignon ◽  
Santiago L. Bongiovanni ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Sport Activity ◽  
Return To Sport ◽  
Bone Block ◽  
Latarjet Procedure ◽  
Revision Procedure ◽  
Significant Difference ◽  
Functional Scores ◽  
Competitive Athletes

Background: The literature lacks evidence comparing outcomes between the Latarjet procedure performed as a primary procedure versus a revision procedure in competitive athletes. Purpose: To compare return to sport, functional outcomes, and complications of the modified Latarjet performed as a primary or revision procedure in competitive athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2008 and June 2015, a total of 100 competitive athletes with recurrent anterior shoulder instability underwent surgery with the congruent arc Latarjet procedure without capsulolabral repair. There were 46 patients with primary repairs and 54 with revisions. Return to sport, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sport 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 by computed tomography. Results: The mean follow-up period was 58 months (range, 24-108 months). A total of 96 patients (96%) returned to competitive sports; 91% returned to 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 statistically significant improvements after surgery ( P < .001). The Rowe score increased from a preoperative mean of 43.8 to a postoperative mean of 96.1 ( P < .01). Subjective pain during sports improved from a preoperative VAS score of 3.3 to a postoperative score of 1.2 ( P < .01). The ASOSS score improved significantly from a preoperative mean of 46.3 to a postoperative mean of 88.1 ( P < .001). No significant differences in shoulder ROM and functional scores were found between patients who underwent a primary versus a revision procedure. No recurrence of shoulder dislocation or subluxation was noted. The bone block healed in 91 patients (91%). Conclusion: In competitive athletes with recurrent anterior glenohumeral instability, the modified Latarjet procedure produced excellent functional outcomes, with most athletes returning to sport at the same level they had before surgery and without recurrence, regardless of whether the surgery was performed as a primary or a revision procedure.

scholarly journals Reasons Why Athletes Do Not Return to Sports After Arthroscopic Bankart Repair: A Comparative Study of 208 Athletes With Minimum 2-Year Follow-up

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110133
Author(s):  
Luciano Andrés Rossi ◽  
Ignacio Tanoira ◽  
Rodrigo Brandariz ◽  
Ignacio Pasqualini ◽  
Maximiliano Ranalletta
Keyword(s):  
Functional Outcomes ◽  
Bankart Repair ◽  
Return To Sports ◽  
Glenohumeral Instability ◽  
Rehabilitation Process ◽  
Arthroscopic Bankart Repair ◽  
Outcome Scores ◽  
Competitive Athletes ◽  
The Mean

Background: There is a lack of information regarding the reasons why patients do not return to sports after an arthroscopic Bankart repair and whether there is a relationship between return to sports and functional outcomes. Purpose: To evaluate the reasons why competitive athletes who underwent arthroscopic Bankart repair did not return to sports and whether there was a relationship between returning to sports and postoperative outcome scores and complications. Study Design: Cohort study; Level of evidence, 3. Methods: Of 217 competitive athletes who underwent arthroscopic Bankart repair for isolated anterior glenohumeral instability between June 2014 and December 2017, a total of 208 athletes (96%) were evaluated at minimum 2-year follow-up. Return to sports, the level of sports achieved, and the time between surgery and return to competition were assessed, and patients who did not return to sports were asked to provide the reasons for cessation. The Rowe score and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences, reoperations, and complications were also evaluated. Results: The mean patient age was 24 years (range, 18-30 years), and the mean follow-up was 44 months (range, 24-90 months). Of the 208 athletes, 73% were able to return to sports (65% returned to their preinjury level), and 27% did not return to sports. Of those who did not return, the most frequent reasons were fear of reinjury (44%), lack of confidence in their shoulder (12%), and concern about a new rehabilitation process in case of recurrence (10%). The Rowe and ASOSS scores showed significant postoperative improvement in all patients ( P < .001), with no significant differences between the 2 study groups at the final follow-up. There were 21 recurrences (10%) and 5 complications (2.4%), and 11 patients (5.3%) underwent revision surgery, with no significant differences in these rates between the groups. Conclusion: Of patients who did not return to sports, 74% left for a reason independent of shoulder function, with the most frequent causes being fear of reinjury and a concern about new rehabilitation process. Neither outcome scores nor complications varied significantly between patients who returned and those who did not return to sports.

Recurrence and Revision Rates With Arthroscopic Bankart Repair Compared With the Latarjet Procedure in Competitive Rugby Players With Glenohumeral Instability and a Glenoid Bone Loss <20%

2021 ◽  
Vol 49 (4) ◽  
pp. 866-872
Author(s):  
Luciano A. Rossi ◽  
Ignacio Tanoira ◽  
Tomás Gorodischer ◽  
Ignacio Pasqualini ◽  
Maximiliano Ranalletta
Keyword(s):  
Bone Loss ◽  
Functional Outcomes ◽  
Return To Sport ◽  
Glenoid Bone Loss ◽  
Bankart Repair ◽  
Latarjet Procedure ◽  
Glenohumeral Instability ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Rugby Players

Background: There is a lack of evidence in the literature comparing outcomes between the arthroscopic Bankart repair and the Latarjet procedure in competitive rugby players with glenohumeral instability and a glenoid bone loss <20%. Purpose: To compare return to sport, functional outcomes, and complications between the arthroscopic Bankart repair and the Latarjet procedure in competitive rugby players with glenohumeral instability and a glenoid bone loss <20%. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2010 and February 2018, 130 competitive rugby players with anterior shoulder instability were operated on in our institution. The first 80 patients were operated on with the arthroscopic Bankart procedure and the other 50 with the open Latarjet procedure. Return to sport, range of motion (ROM), the Rowe score, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences, reoperations, and complications were also evaluated. Results: In the total population, the mean follow-up was 40 months (range, 24-90 months) and the mean age was 24.2 years (range, 16-33 years). Ninety-two percent of patients were able to return to rugby, 88% at their preinjury level of play. Eighty-nine percent of patients in the Bankart group and 87% in the Latarjet group returned to compete at the same level ( P = .788). No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe and ASOSS scores showed statistical improvement after operation ( P < .01). No significant difference in functional scores was found between the groups The Rowe score in the Bankart group increased from a preoperative mean (± SD) of 41 ± 13 points to 89.7 points postoperatively, and in the Latarjet group, from a preoperative mean of 42.5 ± 14 points to 88.4 points postoperatively ( P = .95). The ASOSS score in the Bankart group increased from a preoperative mean of 53.3 ± 3 points to 93.3 ± 6 points postoperatively, and in the Latarjet group, from a preoperative mean of 53.1 ± 3 points to 93.7 ± 4 points postoperatively ( P = .95). There were 18 recurrences (14%). The rate of recurrence was 20% in the Bankart group and 4% in the Latarjet group ( P = .01). There were 15 reoperations (12%). The rate of reoperation was 16% in the Bankart group and 4% in the Latarjet group ( P = .03). There were 6 complications (5%). The rate of complications was 4% in the Bankart group and 6% in the Latarjet group ( P = .55). The proportion of postoperative osteoarthritis was 10% in the Bankart group (8/80 patients) and 12% (6/50 patients) in the Latarjet group ( P = .55). Conclusion: In competitive rugby players with glenohumeral instability and a glenoid bone loss <20%, both the arthroscopic Bankart repair and the Latarjet procedure produced excellent functional outcomes, with most athletes returning to sport at the same level they had before the injury. However, the Bankart procedure was associated with a significantly higher rate of recurrence (20% vs 4%) and reoperation (16% vs 4%) than the Latarjet procedure.

scholarly journals Clinical Outcomes of Shoulder Stabilization in Females With Glenoid Bone Loss

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110075
Author(s):  
Rachel M. Frank ◽  
Hytham S. Salem ◽  
Catherine Richardson ◽  
Michael O’Brien ◽  
Jon M. Newgren ◽  
...  
Keyword(s):  
Bone Loss ◽  
Clinical Outcomes ◽  
Shoulder Instability ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Shoulder Stabilization ◽  
Simple Shoulder Test ◽  
Female Patients

Background: Nearly all studies describing shoulder stabilization focus on male patients. Little is known regarding the clinical outcomes of female patients undergoing shoulder stabilization, and even less is understood about females with glenoid bone loss. Purpose: To assess the clinical outcomes of female patients with recurrent anterior shoulder instability treated with the Latarjet procedure. Study Design: Case series; Level of evidence, 4. Methods: All cases of female patients who had recurrent anterior shoulder instability with ≥15% anterior glenoid bone loss and underwent the Latarjet procedure were analyzed. Patients were evaluated after a minimum 2-year postoperative period with scores of the American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and pain visual analog scale. Results: Of the 22 patients who met our criteria, 5 (22.7%) were lost to follow-up, leaving 17 (77.2%) available for follow-up with a mean ± SD age of 31.7 ± 12.9 years. Among these patients, 16 (94.1%) underwent 1.6 ± 0.73 ipsilateral shoulder operations (range, 1-3) before undergoing the Latarjet procedure. Preoperative indications for surgery included recurrent instability with bone loss in all cases. After a mean follow-up of 40.2 ± 22.9 months, patients experienced significant score improvements in the American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and pain visual analog scale ( P < .05 for all). There were 2 reoperations (11.8%). There were no cases of neurovascular injuries or other complications. Conclusion: Female patients with recurrent shoulder instability with glenoid bone loss can be successfully treated with the Latarjet procedure, with outcomes similar to those of male patients in the previously published literature. This information can be used to counsel female patients with recurrent instability with significant anterior glenoid bone loss.

Structural and Functional Results of Subscapularis and Conjoint Tendon After Latarjet Procedure at 8-Year Average Follow-up

2021 ◽  
pp. 036354652110615
Author(s):  
Sebastien Azizi ◽  
Lukas Urbanschitz ◽  
Susanne Bensler ◽  
Christopher G. Lenz ◽  
Paul Borbas ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Bone Block ◽  
Subscapularis Tendon ◽  
Latarjet Procedure ◽  
Mri Scans ◽  
The Mean ◽  
Rotation Strength ◽  
Nonoperative Side ◽  
Conjoint Tendon

Background: The Latarjet procedure involves initial dissection through a longitudinal split of the subscapularis tendon with only a final partial closure to accommodate the transferred coracoid bone. Furthermore, by transferring the coracoid bone block to the anterior glenoid, the surgeon completely alters the resting and dynamic route of the attached conjoint tendon. The eventual structural and functional integrity of the subscapularis and conjoint tendons is currently unknown. Purpose: To examine the structural and functional integrity of the subscapularis and the conjoint tendon after the Latarjet procedure at an 8-year average follow-up. Study design: Case series; Level of evidence, 4. Methods: Twenty patients with anterior shoulder instability at a mean age of 30 years (range, 19-50 years) underwent the open Latarjet procedure. Clinical examination at the final follow-up included quantitative isometric measurement of abduction and internal rotation strength compared with the nonoperative side. Patients were assessed via radiograph examination and preoperative computed tomography. Final position and healing of the transferred coracoid bone block were evaluated using standard radiographs. At follow-up, the subscapularis and conjoint tendon were evaluated via magnetic resonance imaging (MRI) with metal artifact reduction techniques and via ultrasound. Results: Nineteen of the 20 shoulders remained stable at the final follow-up; there was 1 redislocation (5%) after 14 months. The mean Rowe score was 83 points (SD, 17.9 points), the mean Constant score was 85 points (SD, 8.1 points), and the Subjective Shoulder Value was 80% (SD, 18%). The mean abduction strength of the operative shoulder was 7.41 ± 2.06 kg compared with 8.33 ± 2.53 kg for the nonoperative side ( P = .02). The mean internal rotation strength at 0° for the operative shoulder was 8.82 ± 3.47 kg compared with 9.06 ± 3.01 kg for the nonoperative side ( P = .36). The mean internal rotation strength in the belly-press position for the operative shoulder was 8.12 ± 2.89 kg compared with 8.50 ± 3.03 kg ( P = .13). Four of 20 shoulders showed mild tendinopathic changes of the subscapularis tendon but no partial or complete tear. One patient exhibited fatty degeneration Goutallier stage 1. Conjoint tendon was in continuity in all 20 shoulders on MRI scans. Conclusion: Abduction, but not internal rotation strength, was slightly reduced after the Latarjet procedure at a mean of 8 years of follow-up. The subscapularis tendon was intact based on ultrasound examination, and the conjoint tendon was intact based on MRI scans. Subscapularis muscle girth relative to the supraspinatus muscle remained intact from preoperative measurements based on MRI scans.

scholarly journals Early outcomes of the arthroscopic Latarjet procedure in a series of 37 patients with shoulder instability

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zheng Zeng ◽  
Chuan Liu ◽  
Yang Liu ◽  
Yan Huang
Keyword(s):  
Bone Resorption ◽  
Bone Loss ◽  
Shoulder Dislocation ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Dislocation ◽  
Latarjet Procedure ◽  
Capsular Repair ◽  
Arthroscopic Latarjet ◽  
Arthroscopic Latarjet Procedure

Abstract Background Anterior shoulder dislocation remains a clinical challenge. This study aimed to assess the graft position and clinical outcomes of the arthroscopic Latarjet procedure and capsular repair for the treatment of recurrent anterior shoulder dislocation with significant glenoid bone loss in 37 patients. Methods Between 2017 and 2017, 37 patients underwent arthroscopic Latarjet plus capsular repair procedure for recurrent anterior shoulder dislocation combined with significant glenoid bone loss. In follow-up examinations, Walch-Duplay scores, subjective shoulder value (SSV) scores, Rowe scores, and active range of motion (AROM) were assessed. Three-dimensional computed tomography (CT) was used to evaluate coracoid graft position and bone resorption. A new method of evaluating the position of the coracoid bone block after Latarjet (H-Z method) was developed. Results Thirty-seven patients were included in this study. Follow-up ranged from 6 to 36 months postoperatively (with an average of 13 months). No recurrent dislocation occurred at the final follow-up, and there was no significant effect on the AROM (all p > 0.05). Rowe (from 42.2 ± 5.6 to 91.1 ± 3.3), Walch-Duplay (from 31.5 ± 8.0 to 92.6 ± 3.7), and SSV (from 63.9 ± 6.1 to 79.3% ± 5.0%) scores were improved significantly after surgery (all p < 0.001). CT showed that the 29 patients had varying degrees of bone resorption, and 23 recovered to the preinjury level of motional function within 6–12 months after surgery. Conclusions In active patients with recurrent anterior shoulder dislocations and significant glenoid bone loss, the arthroscopic Latarjet procedure plus capsular repair could restore shoulder stability satisfactory.

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