Advertisement

Open Versus Arthroscopic Latarjet Procedure for the Treatment of Chronic Anterior Glenohumeral Instability With Glenoid Bone Loss

Published:December 20, 2019DOI:https://doi.org/10.1016/j.arthro.2019.09.042

      Purpose

      The purpose of this study was to compare the clinical, functional, and radiographic outcomes of open versus arthroscopic Latarjet procedures.

      Methods

      Between December 2009 to January 2015, all patients older than 18 years of age who were treated with a Latarjet procedure for chronic osseous anterior instability by a single surgeon were included in this retrospective cohort study. Range of motion, strength, Rowe, Western Ontario Shoulder Instability Index (WOSI) scores, and pain level according to the Visual Analog Scale (VAS) were evaluated. In addition, postoperative computed tomography scans were used to evaluate the position of the transferred coracoid, screw orientation, and degree of graft resorption.

      Results

      Forty-eight patients with a mean age of 29.5 years (range 19-59 years) who underwent open (n = 15; group OL) and arthroscopic (n = 33; group AL) Latarjet procedures were included in the study. The mean follow-up was 30.5 months (range 24-50 months). At final follow-up there were significant differences in the mean internal rotation loss (mean of 9° vs 14°, P = .044) favoring open surgery and WOSI (P = .017) scores favoring arthroscopic. No significant differences were detected in mean forward flexion loss (P = .918), external rotation loss (P = .883), Rowe (P = .429), and Visual Analog Scale (P = .208) scores. Mean superoinferior position of the coracoid bone graft was found between the 1:55 and 4:49 o’clock positions (2:05-4:55 for group OL; 1:51-4:47 for group AL) in en-face views. The grafts were placed laterally in 13% (group OL) and 9% (group AL) of patients. The mean α angles of the screws were 11° and 19.2°, respectively (P = .004). The mean graft resorption rates were 21% and 34% (P = .087), respectively.

      Conclusion

      Good functional results were obtained after both open and arthroscopic Latarjet procedures for the treatment of chronic osseous anterior shoulder instability. Comparative analysis showed small but statistically significant differences in internal rotation loss favoring open and in WOSI favoring arthroscopic techniques. All measured radiographic parameters were similar with the exception of a significant difference in alpha angle with improved screw position in open surgery. OL and AL techniques provide similar clinical and radiographic outcomes.

      Level of Evidence

      III; Retrospective cohort study with comparison group.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rosso C.
        • Bongiorno V.
        • Samitier G.
        • Dumont G.D.
        • Szollosy G.
        • Lafosse L.
        Technical guide and tips on the all-arthroscopic Latarjet procedure.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 564-572
        • Yamamoto N.
        • Muraki T.
        • An K.N.
        • et al.
        The stabilizing mechanism of the Latarjet procedure: a cadaveric study.
        J Bone Joint Surg Am. 2013; 95: 1390-1397
        • Longo U.G.
        • Loppini M.
        • Rizzello G.
        • Ciuffreda M.
        • Maffulli N.
        • Denaro V.
        Latarjet, Bristow, and Eden-Hybinette procedures for anterior shoulder dislocation: systematic review and quantitative synthesis of the literature.
        Arthroscopy. 2014; 30: 1184-1211
        • Nourissat G.
        • Delaroche C.
        • Bouillet B.
        • Doursounian L.
        • Aim F.
        Optimization of bone-block positioning in the Bristow-Latarjet procedure: a biomechanical study.
        Orthop Traumatol Surg Res. 2014; 100: 509-513
        • Gupta A.
        • Delaney R.
        • Petkin K.
        • Lafosse L.
        Complications of the Latarjet procedure.
        Curr Rev Musculoskel Med. 2015; 8: 59-66
        • 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.e1241-1245)
        • Marion B.
        • Klouche S.
        • Deranlot J.
        • Bauer T.
        • Nourissat G.
        • Hardy P.
        A prospective comparative study of arthroscopic versus mini-open latarjet procedure with a minimum 2-year follow-up.
        Arthroscopy. 2017; 33: 269-277
        • Randelli P.
        • Fossati C.
        • Stoppani C.
        • Evola F.R.
        • De Girolamo L.
        Open Latarjet versus arthroscopic Latarjet: clinical results and cost analysis.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 526-532
        • Nourissat G.
        • Neyton L.
        • Metais P.
        • et al.
        Functional outcomes after open versus arthroscopic Latarjet procedure: a prospective comparative study.
        Orthop Traumatol Surg Res. 2016; 102: S277-S279
        • Metais P.
        • Clavert P.
        • Barth J.
        • et al.
        Preliminary clinical outcomes of Latarjet-Patte coracoid transfer by arthroscopy vs. open surgery: Prospective multicentre study of 390 cases.
        Orthop Traumatol Surg Res. 2016; 102: S271-S276
        • Lafosse L.
        • Boyle S.
        Arthroscopic Latarjet procedure.
        J Shoulder Elbow Surg. 2010; 19: 2-12
        • Zhu Y.
        • Jiang C.
        • Song G.
        Arthroscopic versus open latarjet in the treatment of recurrent anterior shoulder dislocation with marked glenoid bone loss: a prospective comparative study.
        Am J Sports Med. 2017; 45: 1645-1653
        • Cunningham G.
        • Benchouk S.
        • Kherad O.
        • Ladermann A.
        Comparison of arthroscopic and open Latarjet with a learning curve analysis.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 540-545
        • Shaha J.S.
        • Cook J.B.
        • Song D.J.
        • et al.
        Redefining “critical” bone loss in shoulder instability: functional outcomes worsen with “subcritical” bone loss.
        Am J Sports Med. 2015; 43: 1719-1725
        • Loppini M.
        • Delle Rose G.
        • Borroni M.
        • et al.
        Is the Instability Severity Index Score a valid tool for predicting failure after primary arthroscopic stabilization for anterior glenohumeral instability?.
        Arthroscopy. 2019; 35: 361-366
        • Bhatia S.
        • Frank R.M.
        • Ghodadra N.S.
        • et al.
        The outcomes and surgical techniques of the latarjet procedure.
        Arthroscopy. 2014; 30: 227-235
        • Lafosse L.
        • Boyle S.
        Arthroscopic Latarjet procedure.
        J Shoulder Elbow Surg. 2010; 19: 2-12
        • Gerber C.
        • Nyffeler R.W.
        Classification of glenohumeral joint instability.
        Clin Orthop Rel Res. 2002; 400: 65-76
        • Sugaya H.
        • Moriishi J.
        • Kanisawa I.
        • Tsuchiya A.
        Arthroscopic osseous Bankart repair for chronic recurrent traumatic anterior glenohumeral instability.
        J Bone Joint Surg Am. 2005; 87: 1752-1760
        • Barchilon V.S.
        • Kotz E.
        • Barchilon Ben-Av M.
        • Glazer E.
        • Nyska M.
        A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint.
        Skel Radiol. 2008; 37: 731-736
        • Kraus T.M.
        • Martetschlager F.
        • Graveleau N.
        • et al.
        CT-based quantitative assessment of the surface size and en-face position of the coracoid block post-Latarjet procedure.
        Arch Orthop Trauma Surg. 2013; 133: 1543-1548
        • Kraus T.
        • Graveeau N.
        • Bohu Y.
        • Pansard E.
        • Klouche S.
        • Hardy P.
        Coracoid graft positioning in the Latarjet procedure.
        Knee Surg Sports Traumatol Arthrosc. 2013; 24: 496-501
        • 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
        • Kany J.
        • Flamand O.
        • Grimberg J.
        • et al.
        Arthroscopic Latarjet procedure: is optimal positioning of the bone block and screws possible? A prospective computed tomography scan analysis.
        J Shoulder Elbow Surg. 2016; 25: 69-77
        • Hantes M.E.
        • Venouziou A.
        • Bargiotas K.A.
        • Metafratzi Z.
        • Karantanas A.
        • Malizos K.N.
        Repair of an anteroinferior glenoid defect by the latarjet procedure: quantitative assessment of the repair by computed tomography.
        Arthroscopy. 2010; 26: 1021-1026
        • Samilson R.L.
        • Prieto V.
        Dislocation arthropathy of the shoulder.
        J Bone Joint Surg Am. 1983; 65: 456-460
        • Hurley E.T.
        • Lim Fat D.
        • Farrington S.K.
        • Mullett H.
        Open versus arthroscopic latarjet procedure for anterior shoulder instability: a systematic review and meta-analysis.
        Am J Sports Med. 2019; 47: 1248-1253
        • Cowling P.D.
        • Akhtar M.A.
        • Liow R.Y.
        What is a Bristow-Latarjet procedure? A review of the described operative techniques and outcomes.
        Bone Joint J. 2016; 98-b: 1208-1214
        • Gordins V.
        • Hovelius L.
        • Sandstrom B.
        • Rahme H.
        • Bergstrom U.
        Risk of arthropathy after the Bristow-Latarjet repair: a radiologic and clinical thirty-three to thirty-five years of follow-up of thirty-one shoulders.
        J Shoulder Elbow Surg. 2015; 24: 691-699
        • Hovelius L.
        • Sandstrom B.
        • Saebo M.
        One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study II-the evolution of dislocation arthropathy.
        J Shoulder Elbow Surg. 2006; 15: 279-289
        • Hovelius L.
        • Vikerfors O.
        • Olofsson A.
        • Svensson O.
        • Rahme H.
        Bristow-Latarjet and Bankart: a comparative study of shoulder stabilization in 185 shoulders during a seventeen-year follow-up.
        J Shoulder Elbow Surg. 2011; 20: 1095-1101
        • Mizuno N.
        • Denard P.J.
        • Raiss P.
        • Melis B.
        • Walch G.
        Long-term results of the Latarjet procedure for anterior instability of the shoulder.
        J Shoulder Elbow Surg. 2014; 23: 1691-1699
        • Neyton L.
        • Young A.
        • Dawidziak B.
        • et al.
        Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up.
        J Shoulder Elbow Surg. 2012; 21: 1721-1727
        • Schroder D.T.
        • Provencher M.T.
        • Mologne T.S.
        • Muldoon M.P.
        • Cox J.S.
        The modified Bristow procedure for anterior shoulder instability: 26-year outcomes in Naval Academy midshipmen.
        Am J Sports Med. 2006; 34: 778-786
        • Singer G.C.
        • Kirkland P.M.
        • Emery R.J.
        Coracoid transposition for recurrent anterior instability of the shoulder. A 20-year follow-up study.
        J Bone Joint Surg Br. 1995; 77: 73-76
        • Zimmermann S.M.
        • Scheyerer M.J.
        • Farshad M.
        • Catanzaro S.
        • Rahm S.
        • Gerber C.
        Long-term restoration of anterior shoulder stability: a retrospective analysis of arthroscopic Bankart repair versus open Latarjet procedure.
        J Bone Joint Surg Am. 2016; 98: 1954-1961
        • 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
        • Nourissat G.
        • Delaroche C.
        • Bouillet B.
        • Doursounian L.
        • Aim F.
        Optimization of bone-block positioning in the Bristow-Latarjet procedure: a biomechanical study.
        Orthop Traumatol. 2014; 100: 509-513
        • Hovelius L.
        • Korner L.
        • Lundberg B.
        • et al.
        The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure.
        J Bone Joint Surg Am. 1983; 65: 926-934
        • Willemot L.B.
        • Eby S.F.
        • Thoreson A.R.
        • et al.
        Iliac bone grafting of the intact glenoid improves shoulder stability with optimal graft positioning.
        J Shoulder Elbow Surg. 2015; 24: 533-540
        • Weppe F.
        • Magnussen R.A.
        • Lustig S.
        • Demey G.
        • Neyret P.
        • Servien E.
        A biomechanical evaluation of bicortical metal screw fixation versus absorbable interference screw fixation after coracoid transfer for anterior shoulder instability.
        Arthroscopy. 2011; 27: 1358-1363
        • Ladermann A.
        • Denard P.J.
        • Burkhart S.S.
        Injury of the suprascapular nerve during latarjet procedure: an anatomic study.
        Arthroscopy. 2012; 28: 316-321
        • Neyton L.
        • Barth J.
        • Nourissat G.
        • et al.
        Arthroscopic Latarjet techniques: graft and fixation positioning assessed with 2-dimensional computed tomography is not equivalent with standard open technique.
        Arthroscopy. 2018; 34: 2032-2040
        • Giacomo G.D.
        • Costantini A.
        • de Gasperis N.
        • et al.
        Coracoid bone graft osteolysis after Latarjet procedure: a comparison study between two screws standard technique vs mini-plate fixation.
        Int J Shoulder Surg. 2013; 7: 1-6
        • Kordasiewicz B.
        • Małachowski K.
        • Kicinski M.
        • Chaberek S.
        • Pomianowski S.
        Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)—clinical results at short term follow-up.
        Int Orthop. 2017; 41: 1023-1033
        • Di Giacomo G.
        • Costantini A.
        • de Gasperis N.
        • et al.
        Coracoid graft osteolysis after the Latarjet procedure for anteroinferior shoulder instability: a computed tomography scan study of twenty-six patients.
        J Shoulder Elbow Surg. 2011; 20: 989-995
        • Boileau P.
        • Thelu C.E.
        • Mercier N.
        • et al.
        Arthroscopic Bristow-Latarjet combined with bankart repair restores shoulder stability in patients with glenoid bone loss.
        Clin Orthop Rel Res. 2014; 472: 2413-2424