Arthroscopic Latarjet Technique Combined With Endobuttons: Functional Outcomes in 26 Cases

Abstract

ObjectiveThe cause of anterior shoulder instability is not fully understood and surgical management remains controversial. The objective of this study was to evaluate the results of patients undergoing arthroscopic Latarjet procedure with endobuttons.MethodsA retrospective study of 26 patients undergoing arthroscopic Latarjet procedure with endobuttons to treat anterior shoulder instability. Patients with previous glenohumeral instability, failure of Bankart procedure or Instability Severity Index Score (ISIS) greater than or equal to 6, were included. Patients were assessed by: DASH, UCLA, Rowe, Visual Analog Scale (VAS) of pain and Short-Form 36 (SF36) scores. Correct position and consolidation of the graft were evaluated.ResultsMean age was 31.5 years (16 to 46). Preoperative duration of symptoms was 1.7 years (1 month to 10 years). Mean follow-up was 14.3 (6 to 24) months. Mean postoperative scores were: 10 points in DASH; 1.6 in VAS, where 23 (88%) patients experienced mild pain and 3 (12%) moderate pain; 89 in Rowe; 32 in UCLA and 78 in SF-36. Positioning of the graft was correct in 25 (96%) cases, and was consolidated in 23 (88%). We had two cases of graft fracture (7%) and postoperative migration (7%).ConclusionSurgical treatment using arthroscopic Latarjet with endobuttons is safe and effective, producing good functional outcomes in patients. Level of Evidence IV, Case Series.

Treatment of Recurrent Anterior Shoulder Dislocation Using the Latarjet Technique

“…The Latarjet procedure led to statistically significant improvement according to Rowe score, with the median going from 25 preoperatively to 95 after 24 months. This datum is in accordance with the other authors, who report a mean Rowe from 89 to 95 11 )-( 13 ),( 17 ),( 20 after the procedure.…”

“…The cases also demonstrated that 17% of patients had a positive apprehension test and, although this number is similar to that pointed out by Belangero et al, 19 it is higher than the other national studies, which reported rates from 0% 10 ),( 13 ),( 14 ),( 16 ),( 18 ),( 20 to about 10%. 12 ),( 17 Gilat et al, 9 in the largest sample on the subject, recorded 2% of patients with this symptom.…”

“…We observed a recurrence rate of 4.9%, one dislocation and one subluxation, values close to that reported by meta-analysis by Gilat et al 9 (2.2% and 2.7%, respectively). In national studies, the recurrence rate ranges from 0% 10 ),( 11 ),( 13 ),( 14 ),( 16 ),( 17 ),( 19 ),( 20 to about 4%. 12 ),( 15 ),( 18 However, these data should be analyzed with caution, since the follow-up time varies widely in studies evaluating long-term results, 15 while others include in their sample patients with a minimum follow-up of six months.…”

“… 12 ),( 15 ),( 18 However, these data should be analyzed with caution, since the follow-up time varies widely in studies evaluating long-term results, 15 while others include in their sample patients with a minimum follow-up of six months. 13 ),( 16 ),( 21 Moreover, because the sample of most studies is not very broad, significant percentage variations may occur, given a low level of events.…”

“…These data are in accordance with the other studies, in which positioning errors are described in 3.7% to 10.5% of the samples. 13 ),( 15 )-( 19 ),( 21 Grafts fixed too high or low may be responsible for residual instability, in the same way as excessive medial positioning. Meanwhile, lateral grafts, can lead to limitation range of motion and development of early arthrosis.…”