Purpose
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.
Methods
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.
Results
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).
Conclusions
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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Article info
Publication history
Published online: September 08, 2016
Accepted:
June 23,
2016
Received:
January 31,
2016
Footnotes
The authors report the following potential conflicts of interests or sources of funding: J.D. receives support from Mitek. T.B. receives support from Arthrex France. P.H. receives support from Arthrex France, Zimmer, and Medacta.
Identification
Copyright
© 2016 by the Arthroscopy Association of North America
