International journal of scientific research | 2021
LATARJET PROCEDURE FOR RECURRENT SHOULDER ANTERIOR INSTABILITY WITH LESS THAN 25% GLENOID BONE LOSS- ITS FUNCTIONAL OUTCOME: A PROSPECTIVE STUDY
Abstract
Background: Latarjet procedure for a recurrent anterior shoulder dislocation with more than 25% of bone loss is a standard treatment with good\nfunctional outcome. In glenoid bone loss < than25%, there is no concurrence in the surgery of choice between Bankart repair, Remplissage\nprocedure and Latarjet procedure. This study is aimed to study the functional outcome following Latarjet procedure in recurrent shoulder\ninstability in patients with < than 25% glenoid bone loss and also to assess the instability symptoms and complications following this procedure.\nMethods: It is a Clinical, Prospective and Observational study on thirty patients with recurrent anterior dislocation of shoulder, with less than 25%\nglenoid bone loss treated with Open Latarjet Procedure, at Chettinad Hospital and Research Institute, Kelambakkam, done between Jan 2017 to\nDec 2020, with a minimum follow-up of atleast 1year duration. Patients were post-operatively assessed functionally using Constant shoulder\nscore, Rowe scoring system and the Walch- Duplay index score. Clinical instability was also assessed using the Anterior Apprehension and\nAnterior Drawer Test.\nResults: In our study with thirty patients, who underwent Latarjet procedure, Functional outcome of the patients were assessed using the Constant\nshoulder score, Rowe scoring system and the Walch- Duplay index score. The combined average percentage of Score of Scores of the three scoring\nsystems were 74.46% had Excellent results, 14.42% had Good and 11.12% of patients had Average or Fair results. None of the patients had any\ninstability symptoms post-operatively at the 1year post-op follow-up. Four patients had super\uf001cial Surgical Site Infections and 2 patients had\ndeveloped mild to moderate shoulder stiffness.\nConclusion: The Latarjet gives con\uf001rmationally Excellent to Good functional outcome and aid in the early return to activities of daily living and a\nfewer failure rate. In patients with Recurrent Anterior Shoulder Dislocation, with even less than 25% Glenoid bone loss, it may be pertinent to\nprimarily consider the osseous option of a coracoid transfer (Latarjet) rather than opt for simpler Open Bankart, Arthroscopic Bankart or an\nArthroscopic Remplissage procedure alone. Thus, as a yardstick the bone loss concept, either on the Glenoidal or on the Humeral aspect, alone,\nneed to be the deciding factor. The fact remains that in the athletic or otherwise Recurrent Anterior Shoulder Dislocators, there is also a concomitant\nhumeral component, apart from the apparent and demonstrable Glenoid defect with the “Circle concept”.