Latarjet procedure versus open capsuloplasty in traumatic anterior shoulder dislocation: long-term clinical and functional results
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To compare the results of two different open surgical techniques (open capsuloplasty and Bristow-Latarjet procedure) at a mid- to long-term follow-up (6 years) in patients with recurrent traumatic anterior shoulder dislocations. Methods: Seventy-three patients (73 shoulders, 48 males; 25 females) fulfilled inclusion and exclusion criteria. Patients were classified as group A if operated on with a Bristow-Latarjet procedure (40 patients, 24 males; 16 females) or group B if operated on with an open capsuloplasty (33 patients, 24 males; 9 females). All patients were followed up with physical examination and functional evaluation scores (UCLA, ROWE and WOSI).
In group A, no further episodes of dislocation or subluxation were reported; in group B, one patient (3.3%) reported a new episode of anterior dislocation as a result of a new trauma. No statistical difference in regard of new episodes of shoulder dislocation was found between the two groups (p > 0.05). At physical examination, two patients (5%) of group A and four patients of group B (13.3%) showed a positive apprehension test (p > 0.05); anterior drawer test was positive in six patients (15%) of group A and in nine patients (30%) of group B (p > 0.05). Statistical analysis showed better external rotation in group A (Latarjet group) than in group B. (p = 0.0176). No statistical differences were detected in regard to the scale scores (UCLA, WOSI, Rowe) (p > 0.05). Regarding the return to sport, 29 patients (72.5%) of group A and 18 patients (60%) of group B reported they resumed the same sports activity at the same pre-operative level (p > 0.05).
Open capsuloplasty and Bristow-Latarjet procedure are both validated surgical techniques for the treatment of recurrent shoulder anterior instability. We found no statistical difference in terms of recurrent dislocation rates, clinical shoulder stability tests, and scoring scales. The rate of patients returning to sport was similar after both techniques. However, patients with open capsuloplasty reported a significantly lower recovery of external rotation than patients operated via the Latarjet procedure.
KeywordsOpen capsuloplasty Latarjet procedure Pre-operative Shoulder dislocation
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 2.Simon RR, Sherman SC, Koenigsknecht SJ (2006) Emergency orthopedics: the extremities, 5th. McGraw-Hill, New YorkGoogle Scholar
- 3.Schaider J, Simon RR (2005) Shoulder injuries. In: Wolfson AB, Hendey GW, Hendry PL et al (eds) Clinical practice of emergency medicine. Lippincott Williams & Wilkins, Philadelphia, p 1033Google Scholar
- 4.Sineff SS, Reichman EF (2004) Shoulder joint dislocation reduction. In: Reichman EF, Simon RR (eds) Emergency medicine procedures. McGraw-Hill, New York, p 593Google Scholar
- 5.Simonet WT, Melton LJ 3rd, Cofield RH, Ilstrup DM (1984) Incidence of anterior shoulder dislocation in Olmsted County, Minnesota. Clin Orthop Relat Res 186:186–191Google Scholar
- 6.Rokito AS, Namkoong S, Zuckerman JD, Gallagher MA (1998) Open surgical treatment of anterior glenohumeral instability: an historical perspective and review of the literature. Part I. Am J Orthop (Belle Mead NJ) 27(11):723–725 ReviewGoogle Scholar
- 7.Rokito AS, Namkoong S, Zuckerman JD, Gallagher MA (1998) Open surgical treatment of anterior glenohumeral instability: an historical perspective and review of the literature. Part II. Am J Orthop (Belle Mead NJ) 27(12):784–790 ReviewGoogle Scholar
- 11.Larrain MV, Montenegro HJ, Mauas DM, Collazo CC, Pavón F (2006) Arthroscopic management of traumatic anterior shoulder instability in collision athletes: analysis of 204 cases with a 4- to 9-year follow-up and results with the suture anchor technique. Arthroscopy 22(12):1283–1289CrossRefGoogle Scholar
- 16.Hobby J, Griffin D, Dunbar M, Boileau P (2007) Is arthroscopic surgery for stabilisation of chronic shoulder instability as effective as open surgery? A systematic review and meta-analysis of 62 studies including 3044 arthroscopic operations. J Bone Joint Surg Br 89(9):1188–1196CrossRefGoogle Scholar
- 18.Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49:994–997Google Scholar
- 19.ElAttrache NS (2007) Surgical techniques in sports medicine. Lippincott Williams & Wilkins:177–187Google Scholar
- 25.Kordasiewicz B, Małachowski K, Kicinski M, Chaberek S, Pomianowski S (2017 May) Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)-clinical results at short term follow-up. Int Orthop 41(5):1023–1033. https://doi.org/10.1007/s00264-016-3372-3 CrossRefGoogle Scholar
- 26.Kordasiewicz B, Kicinski M, Małachowski K, Wieczorek J, Chaberek S, Pomianowski S (2018) Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)-computed tomography evaluation at a short term follow-up. Part II Int Orthop 42(5):1119–1128. https://doi.org/10.1007/s00264-017-3739-0 CrossRefGoogle Scholar
- 30.Millett PJ, Clavert P, Warner JJ (2005) Open operative treatment for anterior shoulder instability: when and why? J Bone Joint Surg Am 87:419–432Google Scholar
- 33.Willemot L, De Boey S, Van Tongel A, Declercq G, De Wilde L, Verborgt O (2018) Analysis of failures after the Bristow-Latarjet procedure for recurrent shoulder instability. Int Orthop. https://doi.org/10.1007/s00264-018-4105-6
- 34.Villatte G, Spurr S, Broden C, Martins A, Emery R, Reilly P (2018) The Eden-Hybbinette procedure is one hundred years old! A historical view of the concept and its evolutions. Int Orthop. https://doi.org/10.1007/s00264-018-3970-3