Mid-term outcomes of arthroscopic Latarjet procedure in chronic anterior shoulder instability after failed Bankart surgery or with significant glenoid bone loss.

Abstract

Arthroscopic Latarjet surgery is a technique developed to minimize invasive surgical treatment of anterior shoulder instability. However, compared to an open Latarjet operation, it is considered more technically demanding. The aim of our study was to assess its mid-term success rate in the hands of a surgeon with sufficient experience. We included 32 patients with recurrent anterior shoulder instability in the analysed cohort who had undergone arthroscopic intervention according to Latarjet as a revision after a previous failed Bankart operation or in the case of the significant bone loss of the glenoid. Patients were followed-up according to a defined protocol for an average of 30.2 months (range 12‒60 months). In this study, we present clinical and radiological results of a long-term follow-up evaluated using Rowe, UCLA, and SST scoring systems, comparing ranges of motion, and thorough analysis of CT examinations performed no earlier than 6 months after surgery. Rowe, UCLA and SST scores were determined pre- and postoperatively; the range of motion was compared to the contralateral side. The postoperative score was significantly improved in accordance with the clinical finding in the followed-up group (Rowe: preOP 22.1 points ‒ postOP 97.6 points, UCLA: preOP 19.50 points ‒ postOP 33.30 points, SST: preOP 8.2 points ‒ postOP 11.5). However, the postoperative external rotation remains significantly smaller as compared to the contralateral side. The feared neurovascular damage did not occur in our cohort; one patient (3 %) had an infection in the access portal, which was managed conservatively; one patient (3 %) required revision surgery. Our results demonstrated that when in the hands of experienced surgeon, the arthroscopic Latarjet surgery is an effective surgical method with a low incidence of complications and excellent mid-term clinical outcomes (Fig. 17, Ref. 25).