Similar Results in Return to Sports, Recurrences, and Healing Rates Between the Classic and Congruent-Arc Latarjet for Athletes With Recurrent Glenohumeral Instability and a Failed Stabilization


      To compare the return-to-sport rate, functional outcomes, and complications of the “classic Latarjet” surgery with those of the “congruent arc Latarjet” surgery in athletes with recurrent glenohumeral instability and failed previous stabilization procedures.


      All the included patients were operated between May 2009 and April 2017. The inclusion criteria were athletes with recurrent anterior glenohumeral instability, a glenoid bone defect greater than 20%, at least 1 previous failed stabilization surgery operated with the classic or the congruent-arc Latarjet procedures, and a minimum 2 years of follow-up. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale for pain, and the Athletic Shoulder Outcome Scoring System score were used to assess functional outcomes. Complications were also evaluated.


      A total of 135 athletes were included in the study (55 patients were operated with the classic technique and 80 with the congruent arc technique). The mean follow-up was 40.3 months (range, 24-88 months) and the mean age was 26.5 years (range, 18-45 years). Overall, 87% were able to return to sports and 92% returned at the same level. No significant difference regarding return to sports was found between the groups. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, visual analog scale, and Athletic Shoulder Outcome Scoring System scores showed statistical improvement after operation (P < .001). No significant difference in shoulder ROM and functional scores was found between patients operated with the classic and congruent arc procedures. There were 6 recurrences (4%). There was no significant difference in the recurrence rate between groups. The bone block healed in 92% of the cases.


      In athletes with recurrent anterior glenohumeral instability and a failed previous operative repair, the Latarjet procedure produced excellent functional outcomes and most athletes returned to sport at their preinjury level with a very low rate of recurrences, regardless of whether the Latarjet was performed with the classic or with the congruent arc technique.

      Level of Evidence

      Retrospective comparative study; Level of evidence, 3.
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        • Gowd A.K.
        • Liu J.N.
        • Cabarcas B.C.
        • et al.
        Management of recurrent anterior shoulder instability with bipolar bone loss: A systematic review to assess critical bone loss amounts.
        Am J Sport Med. 2019; 47: 2484-2493
        • Abdul-Rassoul H.
        • Galvin J.W.
        • Curry E.J.
        • Simon J.
        • Li X.
        Return to sport after surgical treatment for anterior shoulder instability: A systematic review.
        Am J Sport Med. 2019; 47: 1507-1515
        • Ranalletta M.
        • Rossi L.A.
        • Bertona A.
        • Tanoira I.
        • Maignon G.D.
        • Bongiovanni S.L.
        Modified Latarjet procedure without capsulolabral repair for the treatment of failed previous operative stabilizations in athletes.
        Arthroscopy. 2018; 34: 1421-1427
        • Knapik D.M.
        • Voos J.E.
        Magnetic resonance imaging and arthroscopic correlation in shoulder instability.
        Sports Med Arthrosc Rev. 2017; 25: 172-178
        • Hurley E.T.
        • Montgomery C.
        • Jamal M.S.
        • et al.
        Return to Play After the Latarjet procedure for anterior shoulder instability: A systematic review.
        Am J Sport Med. 2019; 47: 3002-3008
        • John R.
        • Wong I.
        Innovative approaches in the management of shoulder instability: Current concept review.
        Curr Rev Musculoskelet Med. 2019; : 386-396
        • Cain Jr., E.L.
        • Ryan M.K.
        Traumatic instability: Treatment options and considerations for recurrent posttraumatic instability.
        Sports Med Arthrosc Rev. 2018; 26: 102-112
        • Willemot L.B.
        • Elhassan B.T.
        • Verborgt O.
        Bony reconstruction of the anterior glenoid rim.
        J Am Acad Orthop Surg. 2018; 26: e207-e218
        • Flinkkilä T.
        • Knape R.
        • Nevalainen M.
        • Sirniö K.
        • Ohtonen P.
        • Leppilahti J.
        Previous arthroscopic Bankart repair is an independent risk factor for an inferior outcome after Latarjet procedure.
        Orthop Traumatol Surg Res. 2019; 105: 1481-1485
        • Armitage M.S.
        • Elkinson I.
        • Giles J.W.
        • Athwal G.S.
        An anatomic, computed tomographic assessment of the coracoid process with special reference to the congruent-arc latarjet procedure.
        Arthroscopy. 2011; 27: 1485-1489
        • Boons H.W.
        • Giles J.W.
        • Elkinson I.
        • Johnson J.A.
        • Athwal G.S.
        Classic versus congruent coracoid positioning during the Latarjet procedure: An in vitro biomechanical comparison.
        Arthroscopy. 2013; 29: 309-316
        • Giles J.W.
        • Puskas G.
        • Welsh M.
        • Johnson J.A.
        • Athwal G.S.
        Do the traditional and modified latarjet techniques produce equivalent reconstruction stability and strength?.
        Am J Sport Med. 2012; 40: 2801-2807
        • Montgomery S.R.
        • Katthagen J.C.
        • Mikula J.D.
        • et al.
        Anatomic and biomechanical comparison of the classic and congruent-arc techniques of the Latarjet procedure.
        Am J Sport Med. 2017; 45: 1252-1260
        • Terra B.B.
        • Ejnisman B.
        • De Figueiredo E.A.
        • et al.
        Anatomic study of the coracoid process: Safety margin and practical implications.
        Arthroscopy. 2013; 29: 25-30
        • Dumont G.D.
        • Vopat B.G.
        • Parada S.
        • et al.
        Traditional versus congruent arc latarjet technique: effect on surface area for union and bone width surrounding screws.
        Arthroscopy. 2017; 33: 946-952
        • Burkhart S.S.
        • De Beer J.F.
        • Barth J.R.H.
        • Criswell T.
        • Roberts C.
        • Richards D.P.
        Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss.
        Arthroscopy. 2007; 23: 1033-1041
        • Walch G.
        • Boileau P.
        Latarjet-Bristow procedure for recurrent anterior instability.
        Tech Shoulder Elbow Surg. 2000; 1: 256-261
        • Chuang T.Y.
        • Adams C.R.
        • Burkhart S.S.
        Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability.
        Arthroscopy. 2008; 24: 376-382
        • Araújo C.G.S.
        • Scharhag J.
        Athlete: A working definition for medical and health sciences research.
        Scand J Med Sci Sports. 2016; 26: 4-7
        • 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
        • Rowe C.
        • Patel D.
        • Southmayd W.
        The Bankart procedure: A long-term end-result study.
        J Bone Joint Surg Am. 1978; 60: 1-16
        • Stein T.
        • Linke R.D.
        • Buckup J.
        • et al.
        Shoulder sport-specific impairments after arthroscopic Bankart repair: A prospective longitudinal assessment.
        Am J Sports Med. 2011; 39: 2404-2414
        • Yang J.S.
        • Mazzocca A.D.
        • Cote M.P.
        • Edgar C.M.
        • Arciero R.A.
        Recurrent anterior shoulder instability with combined bone loss: Treatment and results with the modified Latarjet procedure.
        Am J Sports Med. 2016; 44: 922-932
        • 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
        • Samilson R.L.
        • Prieto V.
        Dislocation arthropathy of the shoulder.
        J Bone Joint Surg Am. 1983; 65: 456-460
        • Horner N.S.
        • Moroz P.A.
        • Bhullar R.
        • et al.
        Open versus arthroscopic Latarjet procedures for the treatment of shoulder instability: A systematic review of comparative studies.
        BMC Musculoskelet Disord. 2018; 19: 255
        • 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 Sport Med. 2019; 47: 1248-1253
        • Griesser M.J.
        • Harris J.D.
        • McCoy B.W.
        • Hussain W.M.
        • Jones M.H.
        • Bishop J.Y.
        • Miniaci A.
        Complications and re-operations after Bristow-Latarjet shoulder stabilization: A systematic review.
        J Shoulder Elbow Surg. 2013; 22: 286-292
        • Domos P.
        • Lunini E.
        • Walch G.
        Contraindications and complications of the Latarjet procedure.
        Shoulder Elbow. 2018; 10: 15-24
        • Rossi L.A.
        • Bertona A.
        • Tanoira I.
        • Maignon G.D.
        • Bongiovanni S.L.
        • Ranalletta M.
        Comparison between modified Latarjet Performed as a primary or revision procedure in competitive athletes: A comparative study of 100 patients with a minimum 2-year follow-up.
        Orthop J Sports Med. 2018; 6 (2325967118817233)
        • Hurley E.T.
        • Jamal M.S.
        • Ali Z.S.
        • Montgomery C.
        • Pauzenberger L.
        • Mullett H.
        Long-term outcomes of the Latarjet procedure for anterior shoulder instability: A systematic review of studies at 10-year follow-up.
        J Shoulder Elbow Surg. 2019; 28: e33-e39
        • Bhatia D.N.
        • Kandhari V.
        Bone defect-induced alteration in glenoid articular surface geometry and restoration with coracoid transfer procedures: a cadaveric study.
        J Shoulder Elbow Surg. 2019; 28: 2418-2426
        • 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
        • Gordins V.
        • Hovelius L.
        • Sandström B.
        • Rahme H.
        • Bergström 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
        • Ilg A.
        • Bankes M.J.
        • Emery R.J.
        The intra-and inter-observer reliability of the Samilson and Prieto grading system of glenohumeral arthropathy.
        Knee Surg Sports Traumatol Arthrosc. 2001; 9: 187-190
        • Elsharkawi M.1
        • Cakir B.
        • Reichel H.
        • Kappe T.
        Reliability of radiologic glenohumeral osteoarthritis classifications.
        J Shoulder Elbow Surg. 2013; 22: 1063-1067