J Korean Shoulder Elbow Soc.  2009 Dec;12(2):189-198.

Latarjet Operation for Anterior Shoulder Instability with Glenoid Bone Defect

Affiliations
  • 1Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea. Shoulderrhee@hanmail.net
  • 2Department of Orthopaedic Surgery, Han Il General Hospital, Seoul, Korea.
  • 3Department of Orthopaedic Surgery, Kyung Hee University East-West Neo Medical Center, Seoul, Korea.
  • 4Department of Orthopaedic Surgery, College of Medicine, Konyang University, Daejeon, Korea.

Abstract

PURPOSE
We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect.
MATERIALS AND METHODS
Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure.
RESULTS
The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of 8degrees and 16degrees less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness.
CONCLUSION
The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.

Keyword

Shoulder; Bone Defect; Anterior Shoulder Instability; Three Dimensional CT; Latarjet procedure

MeSH Terms

Arm
Dislocations
Female
Follow-Up Studies
Fractures, Bone
Humans
Male
Muscle Strength
Musculocutaneous Nerve
Shoulder
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