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Arthroscopic Revision Surgery for Failure of Open Latarjet Technique
Adrián Cuéllar1, Ricardo Cuéllar2, Pablo Beltrán de Heredia3
1Deparment of Traumatology and Orthopaedic Surgery of the Galdakao-Usansolo Hospital, Galdácano, Spain.
Purpose:
To evaluate the efficacy in treating pain, limited range of motion, and continued instability of the Latarjet open technique via the use of arthroscopy.
Methods:
A retrospective review of patients who underwent arthroscopic capsule plication after failure of an open Latarjet technique was performed. Revision surgery was indicated in cases of recurrent instability and associated pain. Only patients with a glenoid defect <25% were considered. The Constant and Rowe scores were administered, whereas pain was assessed with a visual analog scale before the reoperation and at 24 months after operation. Radiographs, computed tomography, and CT arthrography scans were performed.
Results:
Twelve patients met the inclusion criteria. All patients had capsular distension and consequently were subjected to a capsuloplasty. Shoulder function, stability, and pain had all improved significantly at 24 months after arthroscopic revision (P < .0001). In particular, the Constant score increased from 44.9 (standard deviation [SD] 7.10) to 89.3 (SD 12.6) points, the Rowe score improved from 49.5 (SD 10.1) to 80.9 (SD 10.9), whereas the visual analog scale pain score decreased from 6.75 (SD 1.17) to 1.38 (SD 1.06).
Conclusions:
Primary open Latarjet with a glenoid bone defect <25% that failed due to capsular redundancy is amenable to successful treatment with arthroscopic capsuloplasty.
Clinical Relevance:
Arthroscopic approaches can offer a good solution for treating previously failed open Latarjet procedures.
Level Of Evidence:
Level IV, therapeutic case series.
