Abstract
The laterjet procedure is an important option in both primary and revision surgeries, especially in anterior shoulder instabilities that progress with glenoid bone loss. 12 patients who had a history of unsuccessful arthroscopic bankart repair and who underwent laterjet procedure in Ankara Atatürk Research and Training Hospital between 2013 and 2017 were included in the study and the patients were evaluated retrospectively. The mean age of the patients was calculated as 27.7 (range 21 to 38 years). Rowe and Walch-Duplay scores and operated shoulder (OS)-healthy shoulder (HS) range of motion (ROM) measurements were used to evaluate patients clinically and functionally. The mean follow-up time of the patients was calculated as 5.5±1.8 years.
Firstly, no dislocation history was recorded in any patient afer the laterjet procedure. The mean Rowe score was calculated as 82.5 (range 60–100). Accordingly, 8 patients had excellent result, 3 patients had good result and 1 patient had fair result. The mean Walch-Duplay score was 81.4 (range 55–100). It was determined as excellent result in 6 patients, good result in 4 patients and fair result in 2 patients. Another data, joint ROM of the OS-HS of patients are shown in the table. There was some limitation in OS compared to the HS. p<0.05 value was accepted as statistically significant. While there was a statistically significant difference in external rotation (OS:35.2º, HS:56.4º)(p=0.003), internal rotation (OS:65.7º, HS:68.1º)(p=0.008) and flexion (OS:171.2º, HS:175.9º)(p=0.012) degrees but there was no statistically significant difference in abduction degrees (OS:164.3º, HS:170.4º) (p=0.089). In radiological evaluation, partial graft resorption was detected in 1 patient, but it was asymptomatic. The osteoarthritis which is one of the complications of laterjet procedure, was not detected radiologically. There are some limitations of the study. Firstly, it is a retrospective study. Secondly, the demographic features of the patients such as age, gender, profession and dominant hand are excluded. Thirdly, the mean follow-up time is not too long. Finally, some of the scales filled in are based on the patient's declaration, which may not yield sufficient objective results.
In conclusion, the laterjet procedure is a suitable and reliable technique even for revision surgery in the treatment of anterior shoulder instability. It gives positive results in terms of shoulder stability and function. The major disadvantage was found to be the limitation of external rotation. Longer follow-up is needed for another outcomes and late complications, such as osteoarthritis.
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