Arthroscopic Latarjet Procedure With 2-Screw Stabilization: Results of Treatment of 156 Cases with a Minimum of 2-Year Follow-Up. Multicenter Study.

Abstract

Background: Various arthroscopic stabilization procedures are associated with recurrence rates ranging from 10.8% to 21.1%. Recurrences occur especially in young male patients participating in contact sport activities. Bony defects of the humeral head and the glenoid predispose not only to subsequent dislocations but also to failure of surgical treatment. This is the group where "bony" procedures such as arthroscopic Latarjet are recommended to provide better stability as the primary treatment.

Material and methods: Patients with traumatic unidirectional anterior shoulder instability treated from 2009 to 2016 with an arthroscopic Latarjet procedure operated on in two centres. Clinical results, including range of motion, Subjective Shoulder Value and Walch-Duplay score, and postpoperative complications were evaluated.

Results: 156 patients were available for follow-up at a minimum of 2 years after surgery. The mean follow-up was 4318 months. Mean age at the time of surgery was 27.9 (16-53) years. At final follow-up, 8 cases of recurrent instability were identified, including 6 cases of recurrent dislocation and two cases of recurrent subluxation. Mean Walch-Duplay score increased from 3019 preoperatively to 8316 (p<0.05) at the last follow-up. An average loss of external rotation of 11.8 (0-70) (p<0.05) when compared with the contralateral shoulder was observed at the last follow-up. Mean Subjective Shoulder Value score was 92.89.4%. 8 (5%) patients presented with loss of shoulder stability. 25 (15.8%) patients reported subjective return to sport anxiety. Eleven (7%) patients complained of anterior compartment pain. The total number of revision surgeries was 14 (8.9%).

Conclusions: 1. The arthroscopic Latarjet procedure can achieve satisfactory clinical outcomes for the treatment of anterior shoulder instability 2. The rate of complications and recurrence does not increase with time and is comparable at a minimum of 2 years follow-up to early results described in literature.