Results Average time of surgery was significantly shorter in ARTHRO than OPEN: respectively 110 and 120 minutes. The number of intra-operative complications was six (12.5%) in OPEN and five (8.1%) in ARTHRO. The results were comparable in both groups, with no significant difference between OPEN and ARTHRO group: satisfaction rate -96.8% and 91.9%, shoulder function -92.2% and 90%, Walch-Duplay score -83.9 and 76.7 respecively. A significant difference was reported in Rowe score: 87.8 in OPEN and 78.9 in ARTHRO. Another significant difference was found in the presence of Bsubjective apprehension^-a term referring to the subjective perception of instability with no signs of instability at clinical examination -28.7% in OPEN and 50% in ARTHRO. Range of motion in both groups were comparable, however patients in OPEN had significantly lower loss of external rotation in adduction to the side comparing to the contralateral shoulder: 7°versus 14°in ARTHRO. Recurrence was reported in three cases in each group: 6.2% in OPEN and 4.8% in ARTHRO. A revision surgery was performed in four patients (9.3%) in OPEN and six (9.7%) in ARTHRO. Radiographic evaluation showed a significantly lower rate (5%) of graft healing problems (fracture, non-union and osteolysis) after arthroscopic stabilisation, however a partial osteolysis of the proximal part of the bone block was significantly more frequent (53.5%). Conclusions The arthroscopic Latarjet stabilisation showed satisfactory and comparable results to open procedure. We recommend further investigation and development of arthroscopic technique.Level of evidence: III
Posterior glenohumeral instability remains a difficult problem. There are still many controversies regarding surgical treatment, due to a lack of understanding the pathomechanical issues leading to posterior instability. This article presents a new arthroscopic technique of posterior bone block augmentation, which we found to be effective, repeatable and successful. This technique can be used for combined soft tissue and bony defects as well as for revisions after previous soft tissue reconstructions.
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