[Clinical follow-up study after open Latarjet procedure in patients with recurrent anterior shoulder dislocation].

ABSTRACT

OBJECTIVE: To investigate the results of treating patients with recurrent anterior shoulder dislocation using open Latarjet technique in a retrospective study, and to discuss the detail of the surgical technique and the results of the procedure. METHODS: In the study, 22 patients with recurrent anterior shoulder dislocation treated with open Latarjet technique were followed up. The average duration of the follow-up was 66.0 months. An X-ray film and a CT scan were performed before the surgery to evaluate the degenerative change of the gleno-humeral joint and the bony defect of the glenoid. An X-ray film and a CT scan were repeated at the end of the final follow-up to find out if there was any progression of the degenerative change of the gleno-humeral joint and if the transferred coracoid process united. Physical examinations, American Shoulder & Elbow Surgeons (ASES) score, Constant-Murley score and Rowe questionnaire were used to evaluate the patients' shoulder function before the surgery and at the end of the final follow-up. RESULTS: Before the surgery the average forward elevation, external rotation and internal rotation were 158.2°±28.7°, 55.3°±15.2° and T10 (T3-buttock) respectively. The average ASES score, Constant-Murley score and Rowe score were 77.6±17.5, 88.3±12.5 and 40.2±12.0, respectively. At the end of the final follow-up, no redislocation happened. The average forward elevation, external rotation and internal rotation were 167.7°±12.7°, 54.3°±16.5° and T10 (T3-L3), respectively(P=0.138, P=0.765, P=0.439).No sigificant restriction was detected after the surgery regarding forward elevation,external rotation and internal rotation. The mean ASES score, Constant-Murley score, and Rowe score significantly improved to 93.7±9.1 (P=0.001), 95.6±5.6 (P=0.008) and 96.4 ±4.4 (P<0.001) respectively after the surgery. A progression of the degenerative change of the gleno-humeral joint was detected in 3 patients. A non-union of the transferred coarcoid was detected in 1 patient. CONCLUSION: Open Latarjet procedure is effective in treating the recurrent anterior shoulder dislocation patient with severe glenoid defect. No significant progression of the degenerative change of the gleno-humeral joint is detected in average 5-year follow-up.