Management of the failed Latarjet procedure

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability

Background:

• The Latarjet procedure is a common treatment for anterior glenohumeral instability.
• Failures can occur, necessitating revision surgery.
• Understanding failure mechanisms is crucial for improving outcomes.

Purpose of the Study:

• To analyze the causes of failure following the Latarjet procedure.
• To evaluate the effectiveness of revision surgery for failed Latarjet procedures.

Main Methods:

• Retrospective review of 15 patients undergoing revision surgery for failed Latarjet.
• Analysis of failure causes including graft issues, malpositioning, and hyperlaxity.
• Assessment of functional outcomes using Rowe score, WOSI, and SSV.

Main Results:

• Common failure causes included graft avulsion, fracture, mispositioning, nonunion, osteolysis, and Hill-Sachs lesions.
• Generalized hyperlaxity was noted in some cases.
• Revision surgery, including Eden-Hybinette and capsular reinforcement, led to stability in most patients, with improved functional scores.

Conclusions:

• Failure after Latarjet procedure is often due to graft-related issues, malpositioning, or hyperlaxity.
• Addressing the specific cause of failure during revision surgery restores stability.
• Revision surgery significantly improves clinical and functional outcomes in patients with failed Latarjet procedures.