Complications of the Latarjet procedure

Abstract

The Latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss; with good to excellent functional results. Despite excellent clinical results, the complication rates are reported between 15 and 30 %. Intraoperative complications such as graft malpositioning, neurovascular injury, and graft fracture can all be mitigated with meticulous surgical technique and understanding of the local anatomy. Nonunion and screw breakage are intermediate-term complications that occur in less than 5 % of patients. The long-term complications such as graft osteolysis are still an unsolved problem, and future research is required to understand the etiology and best treatment option. Recurrent instability after the Latarjet procedure can be managed with iliac crest bone graft reconstruction of the anterior glenoid. Shoulder arthritis is another complication reported after the Latarjet procedure, which poses additional challenges to both the surgeon and patient.

Glenoid Track Instability Management Score: Radiographic Modification of the Instability Severity Index Score

“…Moreover, this more-selective criteria avoids putting as many patients at risk of developing common postoperative complications that are seen after a Latarjet procedure, including graft osteolysis, hardware complications, and development of early-onset osteoarthritis. [31][32][33][34][35][36] By using the ISIS score to guide operative decision making, glenoid bone loss that is visible on x-ray leads to Latarjet as a treatment option, therefore those who end up being treated with Bankart repair have excellent results, as they had minimal bone loss to begin with. Moreover, patients with any visible bone loss on x-ray film in the ISIS-treated patient cohort were stabilized with a Latarjet, which may have significantly decreased the risk of recurrent instability in this group relative to the overall rates seen in the GTIMS patient cohort.…”

The Radiologist’s Primer to Imaging the Noncuff, Nonlabral Postoperative Shoulder

“…Osteolysis does not appreciably affect stability, reinforcing the role of the other stabilizing effects of the Latarjet procedure, including the sling effect and the capsular repair effect (50). Therefore, osteolysis is usually a radiologic finding with minimal clinical importance (47). If, however, osteolysis is related to concomitant screw exposure, pain may develop, necessitating removal.…”

Avaliação comparativa das dimensões do enxerto do coracoide na cirurgia de Latarjet para instabilidade glenoumeral anterior

“…A cirurgia de Latarjet é a técnica de escolha de vários cirurgiões para o tratamento da instabilidade glenoumeral anterior com perda óssea. [1][2][3][4][5][6][7][8][9][10] Ela foi descrita em 1954 por Latarjet, 11 e em 1958, por Helfet. 12 Patte e Debeyre 13 associaram a sutura do ligamento coracoacromial à cápsula, e descreveram o efeito triplo dessa técnica: a) efeito ósseo do processo coracoide fixado à borda da glenoide; b) efeito tirante do tendão conjunto no terço inferior do subescapular; e c) efeito de tensionamento da cápsula pela sutura do ligamento coracoacromial à ela.…”