Arthroscopic Versus Open Latarjet in the Treatment of Recurrent Anterior Shoulder Dislocation With Marked Glenoid Bone Loss: A Prospective Comparative Study

Abstract

Background:

Very few studies have compared open Latarjet versus arthroscopic Latarjet procedures.

Purpose:

To compare the clinical and computed tomographic outcomes between open and arthroscopic Latarjet procedures.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A prospective, comparative study was performed. The open Latarjet group included 44 patients, and the arthroscopic Latarjet group included 46 patients. All patients had more than 2 years of clinical follow-up (range of motion, American Shoulder and Elbow Surgeons [ASES] score, Constant-Murley score, and Rowe score). The position of the transferred coracoid, the screw orientation, and graft resorption were evaluated on computed tomography (CT) scan.

Results:

The surgery time for the open group was significantly shorter than that for the arthroscopic group (P = .003). No recurrent dislocation occurred in either group. The apprehension test was negative in all patients in both groups. At the final follow-up, no significant difference was detected between the open group and the arthroscopic group regarding any of the clinical outcome measurements. The transferred coracoid graft was level with the glenoid in all patients in both groups. The open group had better position in the superior-inferior direction compared with the arthroscopic group (P < .001). No significant difference was found in screw orientation between the 2 groups (P = .102). At 1 year after surgery, patients in the arthroscopic group had significantly less resorption compared with patients in the open group (P = .044).

Conclusion:

Both procedures are effective for the treatment of recurrent anterior shoulder dislocation with marked glenoid bone loss. The open group had better position in the superior-inferior direction compared with the arthroscopic group. At 1 year after surgery, patients in the arthroscopic Latarjet group showed notably less graft resorption compared with patients in the open Latarjet group.

Keywords

anterior shoulder instability Latarjet arthroscopy computed tomography

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