OUTCOME OF LATARJET PROCEDURE FOR RECURRENT ANTERIOR INSTABILITY OF SHOULDER

Muhammad Arozullah*, Md. Matiul Islam, Md. Ahasan Habib and Khan Ashabul Hoque

ABSTRACT

Background: Recurrent anterior shoulder instability is the commonest of all instabilities in human body. Different surgical procedure have been described for treating trecurrent anterior instability of shoulder. The Latarjet procedure is the gold standard technique which addresses these patients to minimize the risk of recurrence in this subset of patients in both athletes and non-athletes alike. Augmentation of the anteroinferior glenoid increases or restores the glenoid diameter to provide stability through a “bone blocking effect”. The “sling effect”, a dynamic effect created by the transfer of the conjoint tendon, provides stabilization in abducted and externally rotated arm positions particularly at mid and end ranges of motion. The conjoined tendon, in its new position, acts to reinforce the inferior subscapularis and anterior inferior capsule. Objective: The purpose of this study was to evaluate the outcome of latarjet procedure for the treatment of recurrent anterior instability of shoulder. Methods: The study included twenty (20) patients with recurrent anterior instability of shoulder who were enrolled from November 2016 to April 2018 through non randomized purposive sampling. They were surgically treated by Latarjet procedure and were analyzed prospectively. The average follow-up time was 12 months, range 5–18 months; The age range was 15–45 years with a mean of 29.05; regarding sex, 17 (85%) patients were male and 3 (15%) were female. The dominant side was affected in 14 (70%) shoulders. Regarding the etiology, 6 (30%) reported road traffic accident, 6 (30%) reported sports injury, fall from height 7 (35%) and heavy weight lifting 1 (5%). Pain, shoulder function, instability (dislocations/subluxation), and Constant-Murley shoulder scores were documented. Results: The average forward flexion, external rotation, internal rotation and abduction of the operated shoulder were 172º, 70º, 70º and 170º respectively with statistical significance for increased range of motion in all planes, compared to previous status. The mean score of Constant-Murley was 87 in the postoperative period. Conclusion: It is concluded that the Latarjet procedure for recurrent anterior instability of shoulder leads to good and excellent results in 95% of cases. Complications are related to errors in technique.

Keywords: Bone blocking effect, Shoulder function, Dislocations, Latarjet procedure.