The Arthroscopically Guided Bristow-Latarjet Procedure With Cortical Button Fixation: A Minimum 10-Year Follow-up

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Instability Research

Background:

• Arthroscopic Latarjet procedure complications persist, often linked to screw fixation and freehand drilling.
• Glenohumeral osteoarthritis (OA) remains a long-term concern despite improved arthroscopic visualization.

Purpose of the Study:

• To evaluate long-term (≥10 years) clinical and radiological outcomes of arthroscopic Bristow-Latarjet with guided drilling and suture button fixation.
• Assess the safety and efficacy of this technique in managing recurrent anterior shoulder instability.

Main Methods:

• A case series of 65 patients (68 shoulders) undergoing arthroscopic Bristow-Latarjet with suture button fixation (2011-2013).
• Minimum 10-year follow-up assessing instability recurrence, complications, range of motion, return to sports, and glenohumeral OA via radiographs and CT scans.

Main Results:

• 94% of patients had no recurrence of instability; 68% returned to sports at the same or higher level.
• No hardware failures or neurological complications were noted. 77% showed no OA development or progression.
• Previous failed Bankart repair was a risk factor for OA development, associated with lower functional scores and reduced external rotation.

Conclusions:

• Arthroscopic Bristow-Latarjet with suture button fixation is a safe and durable treatment for recurrent anterior shoulder instability.
• The procedure facilitates a high return to sports rate with minimal long-term motion restrictions and low OA incidence.
• Guided posterior drilling and suture button fixation offer a reliable alternative to screw fixation for bone graft stability.