Functional Outcome of Open Latarjet Procedure in NonAthletic Middle-Aged Patients

• Main Authors: Joshi S, Rao VKV, Shetty UC, Rai S, Arora S, Kumar SR
• Format: Article
• Language: English
• Published: Malaysian Orthopaedic Association 2021-07-01
• Series: Malaysian Orthopaedic Journal
• Subjects: recurrent anterior shoulder dislocation; bony bankart; hill sachs; open latarjet; coracoid graft
• Online Access: https://www.morthoj.org/2021/v15n2/open-latarjet-procedure.pdf

INTRODUCTION: The movement and steadiness of the shoulder joint is due to both the dynamic and static stabilisers. Recurrent anterior shoulder instability is common due to the Bankart lesion or the Hill Sachs lesion. The bone loss and soft tissue failure due to these lesions causing instability is well compensated by Latarjet procedure which acts by triple blocking effect of the bone graft, the sling effect of the conjoint tendon of subscapularis and the ligament of the coracoacromial ligament stump. MATERIALS AND METHODS: Middle-aged patients with recurrent anterior shoulder dislocation and a mid-range instability on clinical assessment with an isolated glenoid bone loss of 20% or Bankart lesion with engaging Hill Sachs lesion were selected for the study. The surgical procedure included a subscapularis split to expose the glenoid. The coracoid graft harvested was prefixed with Kirschner wires and placed flush over the glenoid ensuring no medial or lateral overhang and fixed with 4.0mm cancellous screws with the washer. The functional outcome was measured with the ROWE score and ASES score and the movements were evaluated. RESULTS: A total of 24 patients fulfilled the inclusion criteria. Post-operatively at final follow-up, the mean ROWE score was 97.08 ±8.45 and the mean ASES score was 94.4±9.10. One patient had screw breakage as a complication and another had restriction of movement which was managed with physiotherapy. CONCLUSION: Open Latarjet is an effective procedure for recurrent anterior shoulder instability in non-athletic middle-aged patients as a excellent functional outcome was achieved with this technique. We therefore recommend open Latarjet as an alternative to arthroscopic treatment in developing countries where patient affordability and the availability of the resources are the issues.