Abstract
Aims – to describe the modifications in technique and outcome of the Latarjet procedure.
Methods – 46 patients were operated on over a six year period. The modifications included a change in orientation of the coracoid bone block and the addition of capsular closure. The procedures were performed by one surgeon for instability associated with antero-inferior glenoid loss. A Walch-Duplay score for instability was produced for each patient at follow-up. All patients had radiological evaluation.
Results – all patients were male with 33 participating at rugby union at a competitive level. The average number of pre-operative dislocations was 5 (range 2 to 20). The average follow-up was 38 months (minimum 6 months). Only one patient had recurrent instability. 31 returned to sport at the same level. The Walch-Duplay scores were as follows; excellent 70%, good 25%, mild 3.75% and poor 1.25%. There were the following complications; 2 fibrous unions (excellent outcome), 3 broken screws (excellent outcome) and two fixation failures (due to patient non compliance). There was no decrease in the range of internal rotation, 8 patients had mild restriction in forward flexion (average 5°) and 20 patients had mildly reduced external rotation at 90° abduction (average 5°). All but one patient (recurrent dislocation) rated their outcome as excellent and would have the operation again.
Discussion – recurrent instability due to bone loss is a difficult problem that is not amenable to traditional stability soft tissue procedures. We feel that the Latar-jet procedure confers excellent stability and produces excellent subjective and objective outcomes
Correspondence should be addressed to BESS c/o BOA, 35-43 Lincoln’s Inn Fields, London WC2A 3PE
