Arthroscopic Latarjet Using a 3 Anterior Portal Technique

Arthroscopic Latarjet is technically challenging with a steep learning curve. Several limitations include the risk of malposition of the coracoid bone block, the risk of screw fixation, such as hardware failure and irritation, and the risk of neurological injury. Initial descriptions of the technique also describe several anterior portals, especially for the subscapularis split. The learning curve is steep, and it is associated with increased risks of complications when compared to the open Latarjet procedure. This technique involves a simplified 3 anterior portal technique, with the portals lateral to the coracoid process and conjoint tendon, reducing the risk of iatrogenic neurovascular injury. Tunnels are created in the glenoid and coracoid process using specific glenoid and coracoid drill guides. This improves coracoid positioning while reducing the risk of neurovascular injury. The coracoid process is also prepared extra-articularly after osteotomy for better visualization, control and efficiency. This simplified arthroscopic Latarjet technique is safe and reproducible in the treatment of recurrent anterior shoulder dislocations.