Functional outcome of latarjet’s procedure for recurrent shoulder dislocation

Abstract

Background: Recurrence of anterior shoulder instability is disabling condition for which treatment options have been insufficiently studied. Our patients don’t seek definitive treatment initially, hence they tend to have engaging hill sacks with or without bony bank arts defect. Coracoid transfer as described by Latar jet and modified by Joe De Beer is one surgery which is suited for recurrent shoulder dislocations. There are various papers mentioning different results. Hence the purpose of this study was to know the functional outcome at two years duration in our set of patients with variable age and occupation.Methods: A cohort formed the basis of retrospective series study was done in tertiary care medical college hospital in Mangalore, Karnataka, India involving twenty-seven patients who underwent Latar jet procedure with congruent ark modification for recurrent anterior glen humeral instability by a single Orthopaedic surgeon in our Institute during July 2015 and Jan 2018. Twenty-four patients were available for follow-up. Clinical outcomes at a mean of three, twelve and twenty-four months postoperatively assessed by the Rowe and SPADI (Shoulder Pain and Disability Index) scores. Standardized anteroposterior and axial radiographs were used to assess the graft position and union.Results: No shoulder dislocations or subluxations observed post-surgery. Unspecified shoulder symptoms of pain were present in two patients. We noticed that there was significant increase in the functional outcome between the 3rd, 12th and the 24th month follow up. At the end of 24months follow up sixteen patients had excellent and remaining eight had good results in terms of Rowe scoring.Conclusions: Later jet procedure with congruent arc modification and adequate rehab can effectively restore anterior glen humeral shoulder stability with good functional results.