Latarjet procedure for anterior shoulder instability: a 24-year follow-up study

Arch Orthop Trauma Surg. 2021 Feb;141(2):189-196. doi: 10.1007/s00402-020-03426-2. Epub 2020 Mar 27.

Abstract

Introduction: Different surgical techniques (open and arthroscopic) have been described for the treatment of post-traumatic recurrent anterior instability. The aim of the surgery is to restore when possible, normal shoulder anatomy by repairing the underlying pathology responsible for the instability. Sometimes other surgical techniques are indicated. The purpose of this retrospective study was to investigate the long-term clinical and radiographic results and complications of the open Latarjet procedure after a minimum follow-up of 24 years.

Materials and methods: A retrospective study was performed for 67 patients treated with an open Latarjet procedure in a single center. Forty of these 67 patients returned for follow-up evaluation and clinical/radiological examination during the year 2018, having had a minimum of 24-year follow-up. Clinical outcomes were analyzed using two functional scores, in addition to the ROM and strength assessment. Radiographic evaluation included several views (AP views in neutral, internal and external rotation and a comparative Bernageau view) RESULTS: A total of 40 patients underwent an open Latarjet procedure. All the patients were avaible for follow-up at an average of 25.6 years. Clinically, no patient reported any episode of dislocation at the time of follow-up. The mean Rowe score and the Walch-Duplay score were 84.5 (range 45-100) and 83.5 (range 55-100), respectively. Non-union/fibrous union was reported in 12.5% of cases, partial resorption of the graft was found in 7.5% of cases, while total resorption was found in 5% of cases. Osteoarthritis was identified in 52.5% (21) of the patients.

Conclusions: This long-term follow-up study demonstrated that the open Latarjet procedure is a safe and reliable technique for recurrent anterior shoulder instability. The Latarjet procedure provides good long-term stability although associated with a slight limitation in external rotation.

Level of evidence: Level III; retrospective cohort comparison; treatment study.

Keywords: Anterior shoulder dislocation; Dislocation arthropathy; Glenohumeral instability; Latarjet; Shoulder instability; Traumatic anterior instability.

MeSH terms

  • Arthroplasty* / adverse effects
  • Arthroplasty* / methods
  • Arthroplasty* / statistics & numerical data
  • Follow-Up Studies
  • Humans
  • Range of Motion, Articular
  • Shoulder Dislocation / surgery*
  • Shoulder Joint / surgery*