1.Functional Outcome of Open Latarjet Procedure in NonAthletic Middle-Aged Patie
Joshi S ; Rao VKV ; Shetty UC ; Rai S ; Arora S ; Kumar SR
Malaysian Orthopaedic Journal 2021;15(No.2):151-158
Introduction: The movement and steadiness of the shoulder
joint is due to both the dynamic and static stabilisers.
Recurrent anterior shoulder instability is common due to the
Bankart lesion or the Hill Sachs lesion. The bone loss and
soft tissue failure due to these lesions causing instability is
well compensated by Latarjet procedure which acts by triple
blocking effect of the bone graft, the sling effect of the
conjoint tendon of subscapularis and the ligament of the
coracoacromial ligament stump.
Materials and methods: Middle-aged patients with
recurrent anterior shoulder dislocation and a mid-range
instability on clinical assessment with an isolated glenoid
bone loss of 20% or Bankart lesion with engaging Hill Sachs
lesion were selected for the study. The surgical procedure
included a subscapularis split to expose the glenoid. The
coracoid graft harvested was prefixed with Kirschner wires
and placed flush over the glenoid ensuring no medial or
lateral overhang and fixed with 4.0mm cancellous screws
with the washer. The functional outcome was measured with
the ROWE score and ASES score and the movements were
evaluated.
Results: A total of 24 patients fulfilled the inclusion criteria.
Post-operatively at final follow-up, the mean ROWE score
was 97.08 ±8.45 and the mean ASES score was 94.4±9.10.
One patient had screw breakage as a complication and
another had restriction of movement which was managed
with physiotherapy.
Conclusion: Open Latarjet is an effective procedure for
recurrent anterior shoulder instability in non-athletic middleaged patients as a excellent functional outcome was achieved
with this technique. We therefore recommend open Latarjet
as an alternative to arthroscopic treatment in developing
countries where patient affordability and the availability of
the resources are the issues.