Long-Term Results of the Latarjet Procedure for the Treatment of Anterior Instability of the Shoulder*

Allain, J.; Goutallier, D; Glorion, Christophe

doi:10.2106/00004623-199806000-00008

Cited by 617 publications

(573 citation statements)

References 25 publications

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“…It is, however, worth noting that all these studies compared open Bankart procedures as opposed to arthroscopic Bankart procedures in this study with Latarjet procedures. Taking into account our long-term followup (mean 6 years) and our strict definition of a recurrent instability, our recurrence rates after the arthroscopic Bankart and Latarjet procedures are comparable to those reported in the literature [1,10,12,15,18,24,32]. Many studies in the literature underestimate the recurrence rate of instability since they have too short followup and do not take into account the postoperative subluxations of the shoulder.…”

Section: Discussionsupporting

confidence: 76%

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The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

Bessière

Trojani

Carlès

et al. 2014

Clinical Orthopaedics &Amp; Related Research

227

188

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Background Arthroscopic Bankart repair and open Latarjet bone block procedure are widely considered mainstays for surgical treatment of recurrent anterior shoulder instability. The choice between these procedures depends mainly on surgeon preference or training rather than published evidence. Questions/purposes We compared patients with recurrent posttraumatic anterior shoulder instability treated with arthroscopic Bankart or open Latarjet procedure in terms of (1) frequency and timing of recurrent instability, (2) risk factors for recurrent instability, and (3) patient-reported outcomes. Methods In this retrospective comparative study, we paired 93 patients undergoing open Latarjet procedures with 93 patients undergoing arthroscopic Bankart repairs over the same period for posttraumatic anterior shoulder instability by one of four surgeons at the same center. Both groups were comparable except that patients in the Latarjet group had more glenoid lesions and more instability episodes preoperatively. Minimum followup was 4 years (mean, 6 years; range, 4-10 years). Patients were assessed with a questionnaire, including stability, Rowe score, and return to sports. Recurrent instability was defined as at least one episode of recurrent dislocation or subluxation. Return to sports was evaluated using a 0% to 100% scale that patients completed after recovery from surgery. Various risk factors for recurrent instability were also analyzed. Results At latest followup, 10% (nine of 93) in the Latarjet group and 22% (20 of 93) in the Bankart group demonstrated recurrent instability (p = 0.026; odds ratio, 0.39; 95% CI, 0.17-0.91). Ten recurrences in the Bankart group (50%) occurred after 2 years, compared to only one (11%) in the Latarjet group. Reoperation rate was 6% and 7% in the Bankart and Latarjet groups, respectively. In both groups, patients younger than 20 years had higher recurrence risk (p = 0.019). In the Bankart group, independent factors predictive for recurrence were practice of competitive sports and shoulder hyperlaxity (ie, passive external rotation [ 85°in the contralateral uninjured shoulder). Although return to sports was not different between groups, the mean Rowe score was higher in the Latarjet group (78 versus 68, p = 0.018). Conclusions Patients who had the open Latarjet procedure had less recurrent instability and better Rowe scores over a mean 6-year followup. We now perform isolated arthroscopic Bankart repair for carefully selected patients, including patients with an Instability Severity Index Score of 3 or less. Level of Evidence Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 76%

“…Rates of recurrence after these two techniques vary widely in the literature, ranging from 0% to 30% for arthroscopic Bankart repair [13,22], with a mean of 9% [18], and from 2% to 14% for the open Latarjet bone block procedure (with two screws and the block in lying down position), with a mean of 7% [1,10,12,15,17,24,32].…”

Section: Introductionmentioning

confidence: 99%

The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

Bessière

Trojani

Carlès

et al. 2014

Clinical Orthopaedics &Amp; Related Research

227

188

View full text Add to dashboard Cite

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“…9,10 The development of osteoarthritis is also a concern. In a long-term study, Allain et al 11 found that grade 2 or higher concentric glenohumeral arthritis developed in 20% of patients at a minimum 10-year follow-up. Because of the concerns arising with the Latarjet procedure, distal tibial allograft has been introduced as an alternative technique.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Distal Tibial Allograft Augmentation for Posterior Shoulder Instability With Glenoid Bone Loss

Gupta

Chalmers

Klosterman

et al. 2013

Arthroscopy Techniques

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Glenoid bone loss is commonly associated with recurrent shoulder instability. Failure to recognize and appropriately address it can lead to poor outcomes. Numerous studies have found anterior-inferior glenoid bone loss in the setting of recurrent anterior instability. Though much less common, posterior shoulder instability can be seen in the setting of acute trauma, epilepsy, electrocution, and alcoholism. Heightened awareness has led to recognition in collision athletes as well. Posterior glenoid bone loss must be addressed in a similar fashion to anterior glenoid bone loss to prevent recurrent instability. Open bone augmentation procedures have been described with successful results. In this technical note, we describe an arthroscopic technique using fresh distal tibial allograft for posterior glenoid augmentation. In addition, a current review regarding the diagnosis and management of recurrent posterior shoulder instability is provided.

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“…Whereas there is consensus that bony glenoid defects >21 % of the glenoid surface must be addressed by anatomical (e.g. Jbone graft [11]) or extra-anatomical reconstructions, such as the Latarjet procedure [12,13], surgical interventions for Hill-Sachs lesions are diverse. For lesions comprising 20-40 %, several approaches have been described ranging from percutaneous correction [14] evaluated in the cadaver model to clinical interventions such as arthroscopic interference screw insertion, remplissage manoeuvres [15], osteochondral allograft transplantations [16] and rotational osteotomies [17].…”

Section: Introductionmentioning

confidence: 99%

“…For lesions comprising 20-40 %, several approaches have been described ranging from percutaneous correction [14] evaluated in the cadaver model to clinical interventions such as arthroscopic interference screw insertion, remplissage manoeuvres [15], osteochondral allograft transplantations [16] and rotational osteotomies [17]. Shenoy et al [18] described the use of the lateral clavicle as an autograft to repair reverse Hill-Sachs defects, and the use of allografts has also been described [13]. Defects involving >40 % of the articular surface often require arthroplasty [19].…”

Section: Introductionmentioning

confidence: 99%

Balloon osteoplasty—a new technique for minimally invasive reduction and stabilisation of Hill–Sachs lesions of the humeral head: a cadaver study

Sandmann

Ahrens

Schaeffeler

et al. 2012

International Orthopaedics (SICOT)

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Purpose Traumatic shoulder dislocation may be complicated by concomitant bony injury of the glenoid rim or the humeral head. In Hill-Sachs lesions, reconstruction techniques vary widely and range from open reduction to tendon transposition or humeral head derotation. These operations are extensive and have questionable outcomes. With the expertise from vertebral compression fracture reduction by kyphoplasty, we examined in a cadaver feasibility study whether reduction of the Hill-Sachs lesion via hydraulic lift might be an anatomical and minimally invasive treatment option. We postulated that the use a of a balloon-assisted kyphoplasty reduction could achieve almost anatomical correction of the defect. Methods We created Hill-Sachs lesions in six humeral specimens and performed a computed tomography (CT) scan before and after reduction with the kyphoplasty system. The entry point at the greater tuberosity and balloon positioning was visualised by fluoroscopy. The size of the HillSachs lesion before and after reduction was measured using CT scans in the axial orientation. Results Using the balloon kyphoplasty system, we achieved a statistically significant reduction (80 % ) of the Hill-Sachs lesion. Conclusion In a preliminary cadaver study we show that using a balloon kyphoplasty system might be an alternative treatment option for Hill-Sachs lesions, with reduced collateral damage that can occur with other minimally invasive techniques. Future work is needed to evaluate the technique under arthroscopic conditions.

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Long-Term Results of the Latarjet Procedure for the Treatment of Anterior Instability of the Shoulder*

Cited by 617 publications

References 25 publications

The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

The Open Latarjet Procedure Is More Reliable in Terms of Shoulder Stability Than Arthroscopic Bankart Repair

Arthroscopic Distal Tibial Allograft Augmentation for Posterior Shoulder Instability With Glenoid Bone Loss

Balloon osteoplasty—a new technique for minimally invasive reduction and stabilisation of Hill–Sachs lesions of the humeral head: a cadaver study

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