Abstract
Background: The Latarjet procedure is used to treat recurrent anterior shoulder instability in patients with bony glenoid loss and/or failed previous stabilisation surgery. It has reportedly high success rates, but recent publications have reported concerns of high complication rates. This study aims to assess the complications and outcomes of the Latarjet procedure in our institution, with a minimum 2-year follow-up and compared it to the current literature. Methods: Patients who underwent the procedure over a 36-month period were included in this study (n=81). Seventy-three (90%) patients in our cohort competed in amateur to professional level sports. The indications for surgery were recurrent instability with associated bony glenoid deficiency and/or previous failed arthroscopic stabilisations. The Oxford Shoulder Instability, Constant Shoulder and QuickDASH scores were recorded pre- and post-operatively, along with post-operative complications and failures. Results: Eight (9.9%) complications were recorded: three re-dislocations, two deep infections, one haematoma, one screw breakage and one case of biceps tendinopathy. The mean pre-operative Oxford Shoulder Instability Score improved from 23.2 ± 10.1 to 37 ± 9.2 following the procedure. The mean Constant Shoulder and quickDASH scores also improved from 55.1 ± 21.2 and 30.3 ± 24.3 to 88.1 ± 9.2 and 17.7 ± 23.5 respectively. 98.6% of the patients returned to their pre-injury level of sports. Conclusion: From this study it can be concluded the Latarjet procedure is an effective surgical treatment for recurrent anterior shoulder instability associated with bony glenoid loss, even in high contact professional athletes. Complication rates are lower than previous recent studies have stated.
Highlights
The Latarjet procedure, first described by Michel Latarjet in 1954 [1], is used for recurrent anterior instability of the glenohumeral joint, most commonly associated with glenoid bone loss, or following failed soft tissue stabilisation procedures
Eighteen (22%) of the Latarjet procedures were performed as a primary operation, whilst 63 (78%) were revisions, with all primary operations being failed arthroscopic stabilisations
We focused on postoperative complications, recurrent instability and functional outcome scores and compared them to current literature
Summary
The Latarjet procedure, first described by Michel Latarjet in 1954 [1], is used for recurrent anterior instability of the glenohumeral joint, most commonly associated with glenoid bone loss, or following failed soft tissue stabilisation procedures. Recent studies examining the outcomes of the Latarjet procedure cite high rates of complications, infection, recurrent instability and neurological injury. A systematic review by Griesser et al, examining 1904 shoulders suggests a similar total complication rate of 30%, with a neurological injury rate of 1.8%, a recurrent instability rate of 5.8% (confirmed anterior dislocation rate of 2.9%), and an infection rate of 1% [11]. The Latarjet procedure is used to treat recurrent anterior shoulder instability in patients with bony glenoid loss and/or failed previous stabilisation surgery. It has reportedly high success rates, but recent publications have reported concerns of high complication rates. This study aims to assess the complications and outcomes of the Latarjet procedure in our institution, with a minimum 2-year follow-up and compared it to the current literature
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