Both Open and Arthroscopic Latarjet Result in Excellent Outcomes and Low Recurrence Rates for Anterior Shoulder Instability

Abstract

Purpose The purpose of this study is to evaluate the patient-reported outcomes of open Latarjet (OL) compared to arthroscopic Latarjet (AL) for anterior shoulder instability. Methods A retrospective review of patients who underwent either OL or AL for anterior shoulder instability between 2011 and 2019 was performed. Recurrent instability, visual analog scale (VAS) score, Shoulder Instability-Return to Sport after Injury (SIRSI), Subjective Shoulder Value (SSV), Western Ontario Shoulder Instability (WOSI) score, patient satisfaction, willingness to undergo surgery again, and return to work/sport (RTW/RTS) were evaluated. A P value of < .05 was considered to be statistically significant. Results Our study included 102 patients in total; 72 patients treated with OL, and 30 treated with AL. There were no demographic differences between the two groups ( P > .05 for all). At final follow up (mean of 51.3 months), there was no difference between those that underwent OL or AL in the reported WOSI, VAS, VAS during sports, SSV, and SIRSI scores, nor in patient satisfaction, or whether they would undergo surgery again ( P > .05). Overall, there was no significant difference in the total rate of RTP (65% vs 60.9%; P = .74), or timing of RTP (8.1 months vs 7 months; P = .35). Additionally, there was no significant difference in the total rate of RTW (93.5% vs 95.5%; P = .75). Overall, 3 patients in the OL group and 2 patients in the AL group had recurrent instability events (6.9% vs 6.7%; P = .96), with no significant difference in the rate of recurrent dislocation (4.2% vs 3.3%; P = .84). Conclusion In patients with anterior shoulder instability, both the OL and AL are reliable treatment options, with a low rate of recurrent instability, and similar patient-reported outcomes.

Open Versus Arthroscopic Latarjet for Recurrent Anterior Shoulder Instability: A Systematic Review and Meta-analysis

“…There was no statistically significant difference in external rotation between the procedures at the last follow-up (MD, 6.23; 95% CI, -2.47 to 14.93; P ¼ . 16).…”

Arthroscopic Latarjet yields better union and prevention of instability compared to arthroscopic bony Bankart repair in shoulders with recurrent anterior instability: a systematic review

“…Of the 37 included datasets, complication rates were reported in 15 (arthroscopic bony Bankart repair, n = 3; arthroscopic Latarjet, n = 12), of which 3 reported rates instead of absolute values [23, 57]. There was no statistical difference in complication rate following arthroscopic bony Bankart repair (0.01; CI 0.00–0.07; I 2 = 0%) compared to arthroscopic Latarjet (0.03; CI 0.00–0.06; I 2 = 47%) (Fig.…”

“…A further 87 studies were excluded after full‐text review. This left 29 eligible studies [1, 7, 8, 11, 14, 16–18, 23, 24, 29–32, 38, 40–45, 47, 48, 53, 55–59] of which 16 assessed arthroscopic bony Bankart repair, 13 assessed arthroscopic Latarjet (Tables 1 and 2). All studies reported preoperative glenoid bone loss: 21 reported mean preoperative glenoid bone loss, of which 4 created subgroups of glenoid bone loss and reported the mean loss of each subgroup, while 8 used a threshold of glenoid bone loss as a part of their inclusion criteria.…”

Editorial Commentary: Free Bone Block With Remplissage Provides Less Translation Than Free Bone Block Alone in Shoulder Instability Patients With Bipolar Bone Loss

“…W e know that a bone block augmentation procedure (e.g., distal tibial allograft/Latarjet) provides excellent results for those patients with recurrent shoulder instability and critical glenoid bone loss. [1][2][3][4][5][6] We also know that the addition of a remplissage procedure to a Bankart repair provides good results for those unstable shoulders with an engaging Hill-Sachs or offtrack lesion. [7][8][9][10] But what about those patients with critical bipolar bone loss.…”