Arthroscopic Latarjet: Indications, Techniques, and Results

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopic Techniques

Background:

• The Latarjet procedure, first described in 1954, is a well-established treatment for shoulder instability.
• An all-arthroscopic technique for the Latarjet procedure was introduced in 2007.
• Indications for the Latarjet procedure vary, with broader use in European centers compared to the United States.

Purpose of the Study:

• To evaluate the efficacy and outcomes of the all-arthroscopic Latarjet procedure for shoulder instability.
• To compare the arthroscopic Latarjet procedure with the traditional open approach regarding outcomes and complications.

Main Methods:

• The arthroscopic Latarjet procedure involves exposing the coracoid and glenoid rim, preparing the coracoid, creating a portal, drilling and osteotomizing the coracoid, transferring it to the glenoid rim, and fixing it with screws.
• Key steps include meticulous preparation of the coracoid graft and its secure fixation to the anterior glenoid.

Main Results:

• Arthroscopic Latarjet has a learning curve but comparable complication rates (<2%) to open surgery, including graft fracture, non-union, and infection.
• Patients report less initial pain with the arthroscopic approach, which equalizes by one month post-surgery.
• Excellent coracoid graft positioning is consistently achieved with the arthroscopic technique, and recurrent instability rates (0.3%-4.8%) are comparable to open Latarjet.

Conclusions:

• The arthroscopic Latarjet procedure is a viable and effective treatment for shoulder instability, offering benefits such as reduced early pain and excellent graft placement.
• It presents comparable complication and recurrence rates to the open Latarjet procedure, making it a favorable alternative for select patient populations.