Abstract

BackgroundAnterior 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.MethodsBetween 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.ResultsThirty-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.ConclusionsIn active patients with recurrent anterior shoulder dislocations and significant glenoid bone loss, the arthroscopic Latarjet procedure plus capsular repair could restore shoulder stability satisfactory.

Highlights

  • Anterior shoulder dislocation remains a clinical challenge

  • Anterior shoulder dislocation accompanied by significant glenoid bone loss has a recurrence rate of 67% after Bankart surgery and 89% in athletes participating in contact sports [3]

  • 23 (62.2%) patients recovered to the preinjury shoulder function level (Fig. 2), and 14 (37.8%) had an improved functional level 6 to 12 months after surgery

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Summary

Introduction

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. Anterior shoulder dislocation accompanied by significant glenoid bone loss has a recurrence rate of 67% after Bankart surgery and 89% in athletes participating in contact sports [3]. In 2007, Lafosse et al [8] firstly reported an allarthroscopic Latarjet surgery, characterized by smaller surgical trauma, fewer complications, and faster postoperative recovery. Since this technique has been increasingly used [8, 9]. Reports assessing the all-arthroscopic operation are limited due to the relatively high difficulty and short time of clinical application of this surgical technique [8,9,10,11,12,13,14]

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