Purpose
To determine the optimal position and orientation of the coracoid bone graft for the
Latarjet procedure for recurrent instability in patients with recurrent anterior instability
and high degrees of glenoid bone loss.
Methods
A systematic review of the literature including the Cochrane Database of Systematic
Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980-2012), and
Medline (1980-2012) was conducted. The following search teams were used: glenoid bone
graft, coracoid transfer, glenoid rim fracture, osseous glenoid defect, and Latarjet.
Studies deemed appropriate for inclusion were then analyzed. Study data collected
included level of evidence, patient demographic characteristics, preoperative variables,
intraoperative findings, technique details, and postoperative recovery and complications
where available.
Results
The original search provided a total of 344 studies. A total of 334 studies were subsequently
excluded because they were on an irrelevant topic, used an arthroscopic technique,
or were not published in English or because they were review articles, leaving 10
studies eligible for inclusion. Given the different methods used in each of the studies
included in the review, descriptive analysis was performed. The duration of follow-up
ranged from 6 months to 14.3 years postoperatively. With the exception of 2 studies,
all authors reported on recurrent shoulder instability after Latarjet reconstruction;
the rate of recurrent anterior shoulder instability ranged from 0% to 8%. Overall
patient satisfaction was listed in 4 studies, each of which reported good to excellent
satisfaction rates of more than 90% at final follow-up.
Conclusions
As noted in this review, the current literature on Latarjet outcomes consists mostly
of retrospective Level IV case series. Although promising outcomes with regard to
a low rate of recurrent instability have been seen with these reports, it should be
noted that subtle variations in surgical technique, among other factors, may drastically
impact the likelihood of glenohumeral degenerative changes arising in these patients.
Level of Evidence
Level IV, systematic review of Level IV studies.
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Article info
Publication history
Accepted:
October 28,
2013
Received:
August 28,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
