Recurrent anterior shoulder dislocation treated by latarjet procedure

Arthroscopic Bankart Repair (ABR) provides acceptable results for recurrent anterior shoulder dislocation. However, recent studies have shown recurrent rates of 4-19% or even up to 35-40% in patients aged <25 years, and the results tend to get worse after long-term follow-up. The Latarjet procedure can improve anterior stability by multiple mechanisms, not only can the Bankart lesion be repaired and provide stability, but the transfer of the coracoid process extends the bony articular arc of the glenoid, and the addition of the conjoint tendon may provide dynamic stability as well. The Latarjet procedure for correcting recurrent anterior shoulder dislocation led to good and excellent results in 82.7% of the cases. The Latarjet procedure had the lowest re-dislocation rate, which was significantly lower than the arthroscopic Bankart repair. Latarjet procedure is effective in terms of restoring anteroinferior glenohumeral stability and good option for failed arthroscopic Bankart repair. Recurrence rates of instability are acceptable and re-operation rates were low.

Download Full-text

Outcomes of the Latarjet Procedure in Recurrent Anterior Shoulder Instability due to Tramadol-Induced Seizure

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v7i2.7000 ◽

2021 ◽

Author(s):

Mohammadreza Guity ◽

Arvin Najafi ◽

Pejman Mansouri ◽

Nima Bagheri

Keyword(s):

Shoulder Instability ◽

Shoulder Dislocation ◽

External Rotation ◽

Treatment Method ◽

Anterior Shoulder Instability ◽

Anterior Shoulder Dislocation ◽

Latarjet Procedure ◽

Seizure Episode ◽

Time Of Operation ◽

Recurrent Anterior Shoulder Instability

Background: This study was aimed to evaluate the final results of surgical treatment (Latarjet procedure) in the recurrent anterior shoulder instability following episodes of tramadol-induced seizure. Methods: From January 2005 to March 2013, 47 patients with recurrent anterior shoulder dislocation after suffering a seizure episode following tramadol use underwent surgical procedure. There were 53 shoulders in 47 male patients (six had bilateral recurrent dislocations). The mean age of the patients at the time of operation was 24.7 years (ranging from 20 to 44 years). The average number of episodes of anterior shoulder dislocation before surgery was 16. Results: External rotation with the elbow at the side improved from 45.8 ± 9.3° (30°-60°) pre-operatively to 61.5 ± 7.8° (45°-90°) postoperatively (P < 0.001). Forward elevation also increased significantly post-operatively (P = 0.002). Mean pre-operative Rowe score was 28.41 ± 4.30 (30-85) which increased to 73.57 ± 8.40 post-operatively. The Western Ontario Shoulder Instability Index (WOSI) score decreased from 1352 ± 74 to 618 ± 46 (P < 0.0001). Conclusion: Correcting glenoid bone loss by Latarjet procedure combined, if necessary, with humeral head defect reconstruction could be a proper treatment method in patients experiencing recurrent anterior shoulder dislocation after idiosyncratic seizure reaction of tramadol.

Download Full-text

Latarjet procedure in patients with multiple recurrent anterior shoulder dislocation and generalized ligamentous laxity

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-014-1558-1 ◽

2014 ◽

Vol 25 (4) ◽

pp. 705-708 ◽

Cited By ~ 8

Author(s):

Amr Abdelhady ◽

Maged Abouelsoud ◽

Mohamed Eid

Keyword(s):

Shoulder Dislocation ◽

Anterior Shoulder Dislocation ◽

Latarjet Procedure ◽

Ligamentous Laxity

Download Full-text

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

10.36106/6205163 ◽

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”.

Download Full-text

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

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04726-3 ◽

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.

Download Full-text