Original Article| Volume 33, ISSUE 2, P269-277, February 2017

A Prospective Comparative Study of Arthroscopic Versus Mini-Open Latarjet Procedure With a Minimum 2-Year Follow-up

Published:September 08, 2016DOI:


      To compare postoperative pain during the first postoperative week and the position of the coracoid bone block at the anterior aspect of the glenoid after the arthroscopic and the mini-open Latarjet procedure. The secondary purpose was to assess functional results and recurrence after at least 2 years of follow-up.


      This comparative prospective study included patients who underwent a Latarjet-Bristow procedure for anterior shoulder instability in 2012. The Latarjet procedure was performed by a mini-open approach (G1) in one center and by an arthroscopic approach (G2) in the other. The main evaluation criterion was average shoulder pain during the first postoperative week assessed by the patient on a standard 10-cm visual analog scale (0-10). Secondary criteria were consumption of analgesics during the first week, the position of the coracoid bone block on radiograph and computed tomography scan at the 3-month follow-up and clinical outcomes (Western Ontario Score Index and new surgery) after at least 2 years of follow-up.


      Fifty-eight patients were included, 22 G1 and 36 G2, 13 women and 45 men, mean age 26.9 ± 7.7 years. The mean follow-up was 29.8 ± 4.4 months. There was significantly less pain in the arthroscopic Latarjet group than in the mini-open group during the first postoperative week (2.5 ± 1.4 vs 1.2 ± 1.2, P = .002) with comparable consumption of analgesics (P > .05). The arthroscopic Latarjet procedure resulted in a more lateral coracoid bone block (P = .04) and a better equatorial position than the mini-open technique (P = .02). Three patients underwent revision surgery (1 recurrence [2.8%], 1 block fracture, 1 screw ablation) in the arthroscopic group, none in the mini-open group (P = .54). At the final follow-up, the Western Ontario Score Index score was good in all patients (G1: 78.5 ± 7.5% vs G2: 82.3 ± 7%, P = .03).


      This prospective comparative study showed that the arthroscopic Latarjet procedure was significantly less painful than the mini-open procedure during the first postoperative week. The clinical outcomes were comparable after at least 2 years of follow-up.

      Level of Evidence

      Level II, prospective comparative study.
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        • Tauber M.
        • Resch H.
        • Forstner R.
        • Raffl M.
        • Schauer J.
        Reasons for failure after surgical repair of anterior shoulder instability.
        J Shoulder Elbow Surg. 2004; 13: 279-285
        • Bhatia S.
        • Frank R.M.
        • Ghodadra N.S.
        • et al.
        The outcomes and surgical techniques of the Latarjet procedure.
        Arthroscopy. 2014; 30: 227-235
        • Hovelius L.K.
        • Sandstrom B.C.
        • Rosmark D.L.
        • Saebo M.
        • Sundgren K.H.
        • Malmqvist B.G.
        Long-term results with the Bankart and Bristow-Latarjet procedures: Recurrent shoulder instability and arthropathy.
        J Shoulder Elbow Surg. 2001; 10: 445-452
        • Meyer A.
        • Klouche S.
        • Bauer T.
        • Rousselin B.
        • Hardy P.
        Residual inferior glenohumeral instability after arthroscopic Bankart repair: Radiological evaluation and functional results.
        Orthop Traumatol Surg Res. 2011; 97: 590-594
        • Itoi E.
        • Lee S.B.
        • Berglund L.J.
        • Berge L.L.
        • An K.N.
        The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: A cadaveric study.
        J Bone Joint Surg Am. 2000; 82: 35-46
        • Burkhart S.S.
        • De Beer J.F.
        Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.
        Arthroscopy. 2000; 16: 677-694
        • Latarjet M.
        [Treatment of recurrent dislocation of the shoulder].
        Lyon Chir. 1954; 49: 994-997
        • Young A.A.
        • Maia R.
        • Berhouet J.
        • Walch G.
        Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint.
        J Shoulder Elbow Surg. 2011; 20: S61-S69
        • Allain J.
        • Goutallier D.
        • Glorion C.
        Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder.
        J Bone Joint Surg Am. 1998; 80: 841-852
        • Bessiere C.
        • Trojani C.
        • Carles M.
        • Mehta S.S.
        • Boileau P.
        The open Latarjet procedure is more reliable in terms of shoulder stability than arthroscopic Bankart repair.
        Clin Orthop Relat Res. 2014; 472: 2345-2351
        • Lafosse L.
        • Lejeune E.
        • Bouchard A.
        • Kakuda C.
        • Gobezie R.
        • Kochhar T.
        The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability.
        Arthroscopy. 2007; 23: 1242.e1-1242.e5
        • Lafosse L.
        • Boyle S.
        Arthroscopic Latarjet procedure.
        J Shoulder Elbow Surg. 2010; 19: 2-12
        • Balg F.
        • Boileau P.
        The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation.
        J Bone Joint Surg Br. 2007; 89: 1470-1477
        • Young A.A.
        • Baba M.
        • Neyton L.
        • Godeneche A.
        • Walch G.
        Coracoid graft dimensions after harvesting for the open Latarjet procedure.
        J Shoulder Elbow Surg. 2013; 22: 485-488
        • Kraus T.M.
        • Graveleau N.
        • Bohu Y.
        • Pansard E.
        • Klouche S.
        • Hardy P.
        Coracoid graft positioning in the Latarjet procedure.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 496-501
        • Kirkley A.
        • Griffin S.
        • McLintock H.
        • Ng L.
        The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. The Western Ontario Shoulder Instability Index (WOSI).
        Am J Sports Med. 1998; 26: 764-772
        • Dumont G.D.
        • Fogerty S.
        • Rosso C.
        • Lafosse L.
        The arthroscopic Latarjet procedure for anterior shoulder instability: 5-year minimum follow-up.
        Am J Sports Med. 2014; 42: 2560-2566
        • Onwuegbuzie A.J.
        • Leech N.L.
        Post hoc power: A concept whose time has come.
        Understand Stat. 2004; 3: 201-230
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        Lawrence Erlbaum Associates, Hillsdale, NJ1988
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
        • Todd K.
        • Funk K.
        • Funk J.
        • Bonacci R.
        Clinical significance of reported changes in pain severity.
        Ann Emerg Med. 1996; 27: 485-489
        • Gallagher E.
        • Liebman M.
        • Bijur P.
        Prospective validation of clinically important changes in pain severity measured on a visual analog scale.
        Ann Emerg Med. 2001; 38: 633-638
        • Lunn J.V.
        • Castellano-Rosa J.
        • Walch G.
        Recurrent anterior dislocation after the Latarjet procedure: Outcome after revision using a modified Eden-Hybinette operation.
        J Shoulder Elbow Surg. 2008; 17: 744-750
        • Casabianca L.
        • Gerometta A.
        • Massein A.
        • et al.
        Graft position and fusion rate following arthroscopic Latarjet.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 507-512
        • Boileau P.
        • Mercier N.
        • Roussanne Y.
        • Thelu C.E.
        • Old J.
        Arthroscopic Bankart-Bristow-Latarjet procedure: The development and early results of a safe and reproducible technique.
        Arthroscopy. 2010; 26: 1434-1450
        • Arrigoni P.
        • Huberty D.
        • Brady P.C.
        • Weber I.C.
        • Burkhart S.S.
        The value of arthroscopy before an open modified Latarjet reconstruction.
        Arthroscopy. 2008; 24: 514-519
        • Castricini R.
        • De Benedetto M.
        • Orlando N.
        • Rocchi M.
        • Zini R.
        • Pirani P.
        Arthroscopic Latarjet procedure: Analysis of the learning curve.
        Musculoskelet Surg. 2013; 97: 93-98
        • Cunningham G.
        • Benchouk S.
        • Kherad O.
        • Lädermann A.
        Comparison of arthroscopic and open Latarjet with a learning curve analysis.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 540-545
        • Kirkley A.
        • Werstine R.
        • Ratjek A.
        • Griffin S.
        Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: Long-term evaluation.
        Arthroscopy. 2005; 21: 55-63
        • Shah A.A.
        • Butler R.B.
        • Romanowski J.
        • Goel D.
        • Karadagli D.
        • Warner J.J.
        Short-term complications of the Latarjet procedure.
        J Bone Joint Surg Am. 2012; 94: 495-501