Outcome analysis of management of recurrent shoulder dislocation by latarjet procedure

Introduction: With the extreme range of movements, the shoulder joint is prone for dislocations. This could be due to traumatic or atraumatic, though the majority are atraumatic. With each subsequent episode of dislocation, humeral head, the glenoid, capsule, labrum and the ligaments undergoes progressive degeneration which further worsens the situation. Selecting an optimal and efficient surgical procedure for patients with anterior glenohumeral instability and associated glenoid bone loss is a complex problem. Among the coracoid transfer procedures, open laterjet procedure offers good clinical outcomes even with engaging Hill sach’s along with glenoid bone loss. The purpose is to study the clinical outcome of Open Laterjet procedure in anterior glenohumeral instability and even with Hill Sach’s lesion. Materials & Methods: Twenty patients with recurrent dislocation were performed Open Laterjet Procedure. All patients were screened by arthroscopy through standard portals of the shoulder before open procedure. Patients were followed up for mean period of 22 months. The functional outcome was measured with Walch Duplay and Visual analog scores. Results: All twenty patients had solid bone union. 90% of the patients had excellent to good outcomes. 10% of these patients had developed Grade 1 Humeral Arthropathy and this is due to improper instrument selection. One patient had transient axillary nerve weakness which recovered fully within 3 months period. During the first 10 months, there is significant loss of external rotation. But during 18 to 20 months period, there is significant improvement in the range of external rotation. None of the patient developed recurrent dislocation or positive apprehension. All patients have resorted back to routine work after 6 months period. Conclusion: Open latarjet procedure offers a good surgical method of management of recurrent anterior shoulder dislocation with significant bone loss and our study showed good functional outcome as measured by Walch Duplay and VAS scores.