The modified Latarjet procedure in the treatment of anterior shoulder instability with significant bone loss: a case series
Ahmed Farid Mekky, Chiara FOSSATI, Alessandra Menon, Pietro Simone Randelli, Tarek Ahmed Aly
Abstract
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Ahmed Farid Mekky, Chiara FOSSATI, Alessandra Menon, Pietro Simone Randelli, Tarek Ahmed Aly
Abstract
Open-access reader
Abstract Background Recurrent anterior shoulder instability is a common problem and may be associated with glenoid bone defects. It is important to treat these bone defects appropriately because they are a cause of failed instability repair. Surgical procedures including Latarjet are the usual treatment for anterior shoulder instability associated with significant glenoid bone defects. The aim of this study was to evaluate the clinical outcome and gleno-humeral arthritis progression in patients with recurrent anterior shoulder instability and significant bone loss treated by a modified Latarjet procedure. Methods From July 2018 to November 2021, 21 patients with recurrent anterior shoulder instability associated with significant bone defects were treated by a modified Latarjet procedure. The patients were post-operatively assessed using modified Rowe scoring. Results The mean age at time of surgery was 28.52 ± 8.0 (range: 19–45) years. The mean number of dislocations was 18.33 ± 8.67 (range: 6–35) times. The mean glenoid defect size was 26.19 ± 4.85 (range: 21–37) % and Hill-Sachs lesions were off track in 19 cases. The mean follow-up period was 30.67 ± 7.53 (range: 16–40) months. Eighteen patients (85.7%) showed good to excellent results. The mean modified Rowe score was 85.00 ± 18.77 (range: 30–100) points. The mean external rotation loss was 8.09 ± 5.11° (range: 0–20°). None of the patients showed recurrence of instability and arthritis progression. Conclusion The modified Latarjet is an effective and reliable surgical option to treat traumatic anterior shoulder instability with significant bone loss. Most of the reported complications associated with this procedure didn’t affect the functional outcome.
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Abstract Background Recurrent anterior shoulder instability is a common problem and may be associated with glenoid bone defects. It is important to treat these bone defects appropriately because they are a cause of failed instability repair. Surgical procedures including Latarjet are the usual treatment for anterior shoulder instability associated with significant glenoid bone defects. The aim of this study was to evaluate the clinical outcome and gleno-humeral arthritis progression in patients with recurrent anterior shoulder instability and significant bone loss treated by a modified Latarjet procedure. Methods From July 2018 to November 2021, 21 patients with recurrent anterior shoulder instability associated with significant bone defects were treated by a modified Latarjet procedure. The patients were post-operatively assessed using modified Rowe scoring. Results The mean age at time of surgery was 28.52 ± 8.0 (range: 19–45) years. The mean number of dislocations was 18.33 ± 8.67 (range: 6–35) times. The mean glenoid defect size was 26.19 ± 4.85 (range: 21–37) % and Hill-Sachs lesions were off track in 19 cases. The mean follow-up period was 30.67 ± 7.53 (range: 16–40) months. Eighteen patients (85.7%) showed good to excellent results. The mean modified Rowe score was 85.00 ± 18.77 (range: 30–100) points. The mean external rotation loss was 8.09 ± 5.11° (range: 0–20°). None of the patients showed recurrence of instability and arthritis progression. Conclusion The modified Latarjet is an effective and reliable surgical option to treat traumatic anterior shoulder instability with significant bone loss. Most of the reported complications associated with this procedure didn’t affect the functional outcome.
Key concepts: Latarjet procedure, Anterior shoulder, Medicine, Surgery, Anterior shoulder dislocation, Range of motion, Shoulder joint, Instability