Functional outcome of Latarjet procedure in anterior recurrent shoulder instability

Abstract

The Latarjet procedure is a surgical technique which was described by Michel Latarjet in France in 1954. He described it as an open stabilization technique of the glenohumeral joint in patients with recurrent anterior glenohumeral instability. It is a procedure of combination of coracoid process bone graft and a form of stability provided by the conjoined and subscapularis tendons. The benefits of the procedure are provision of stability, restoration of range of shoulder motion, preservation of shoulder muscle strength and return to premorbid activities of daily living. Patients with recurrent anterior shoulder dislocation with bone loss the bone blocking technique of Laterjet is the technique of choice. This technique has been effective in 98% of patients in avoiding recurrence without losing external rotation. Hence, present study was aimed to determine the functional outcome of open Laterjet procedure for recurrent shoulder dislocation. Case series was conducted based on post-operative Laterjet cases in a government tertiary care centre and medical college, involving 20 patients who underwent Latarjet’s procedure, with duration 1st January 2023 to 31st December 2023 patients of either gender or age more than 18 years with recurrent anterior shoulder dislocation. Ethical clearance was obtained from the institutional ethics committee. The indication for the Laterjet procedure was defined with preoperative clinical findings proving recurrence of anterior shoulder instability and confirming the cause of dislocations with radiographs and MRI scans. In the included subject’s complete history, physical examination and relevant investigations were done. The incidence of poor, fair, good, and very good outcomes was found to be 1 (5%), 2 (10%), 14 (70%), and 3 (15%) respectively. There was significant improvement in shoulder motion and reduction in pain after 6th month's follow-up. We reported re-dislocation in 1 patient. Mean VAS (Visual analogue scale) for pain among the patients in the study also reduced from pre-operative value of 7.2 to 6.5, 4.5 and 1.5 at 6 week, 3 months and 6 months postop respectively and this reduction in pain was found to be highly significant. Recurrent anterior shoulder dislocation can be effectively treated by open Latarjet technique being a safe and reliable treatment alternative with good functional outcomes. Surgeons should be aware that these procedures are technically demanding.