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Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss.

ABSTRACT: Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency. The following Technical Note provides a diagnostic approach for suspected glenohumeral instability, as well as a detailed description of the congruent-arc Latarjet procedure, performed with a deltoid split, with its postoperative management.

SUBMITTER: McHale KJ

PROVIDER: S-EPMC5495908 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss.

McHale Kevin J KJ Sanchez George G Lavery Kyle P KP Rossy William H WH Sanchez Anthony A Ferrari Marcio B MB Provencher Matthew T MT

Arthroscopy techniques 20170619 3

Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than ...[more]

PMID: 28706833

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Project description:BackgroundA paucity of literature exists on the outcomes after Latarjet for anterior shoulder instability in patients with seizure disorders (SDs). The purpose of this study was to determine the effectiveness of the Latarjet procedure for anterior shoulder instability in patients with SDs.MethodsA retrospective review of patients undergoing Latarjet from 2013 to 2017 for anterior shoulder instability with minimum 2 years of clinical follow-up was performed. Patients were divided into two groups: patients diagnosed with SD, and patients without a history of seizure (control). Demographics, indications, SD details, and postoperative outcomes were collected. The incidence of complications, recurrent instability, revision surgery, and repeat seizure(s) were also examined.ResultsA total of 53 patients were identified, including 10 shoulders in 9 patients with an SD (88.9% male; mean age, 29.2 years [range, 20-37]), and 44 shoulders in 44 non-SD patients (86.4% male; mean age, 30.3 years [range, 18-52]). The mean follow-up time was 3.4 (range, 2.2-4.8) and 3.8 (range, 2.1-5.6) years in the SD and control group, respectively. During the follow-up period, 4 of 9 (44.4%) patients with an SD (50% shoulders) had a recurrent seizure postoperatively. Of those 4 patients, three sustained a recurrent dislocation of the operative shoulder(s) resulting from a postoperative seizure, including one who dislocated bilateral shoulders from a single seizure event after bilateral Latarjet procedures. There was no recurrent instability in patients who did not sustain a seizure in the postoperative period. Having a seizure in the postoperative period significantly increased the risk of recurrent dislocation (OR = 39.9, P = 0.04).ConclusionsLatarjet is a successful operation for recurrent anterior shoulder instability in patients without an SD. While it can still be successful in patients with SD, adequate control of seizures postoperatively is paramount to prevent recurrent instability episodes. Patients with an SD can be advised that if their seizures can remain controlled, they have a high likelihood of clinical success equal to that of patients without an SD.

Dataset Information

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss.

Publications

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss.

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