Comparison of Modified Latarjet Procedure With Bone Graft Versus Standard Latarjet Procedure: Evaluating Outcomes and Stability

TL;DR

This study compares two versions of the Latarjet procedure for shoulder instability, finding both effective but with slight advantages for the modified technique using iliac bone grafts.

Contribution

The study introduces a modified Latarjet procedure using iliac bone grafts and compares it with the standard technique in terms of outcomes and stability.

Findings

Both modified and standard Latarjet procedures improved shoulder stability and functional scores with no recurrent instability.

Modified Latarjet showed slightly better functional scores and range of motion but had donor site pain in one patient.

Graft union was achieved in all patients, though one standard procedure patient experienced graft resorption.

Abstract

Background: The Latarjet procedure is a well-established technique for managing repeated anterior shoulder dislocation accompanied by massive glenoid bone loss. Aim of this article was to assess outcomes among modified Latarjet procedure using allograft from Iliac bone and a standard Latarjet procedure using the coracoid process.

Methods: Six patients with recurrent anterior shoulder instability and significant glenoid bone loss were retrospectively analyzed. Three patients underwent the modified Latarjet procedure with iliac crest bone graft (Group A), and three underwent the standard Latarjet procedure (Group B). Outcomes were assessed at the 12-month follow-up, including shoulder stability, functional scores (Constant, the American Shoulder and Elbow Surgeons (ASES) score, and the Western Ontario Shoulder Instability Index (WOSI)), range of motion, complications, and return to sports.

Results: Both groups showed improvements in stability and functional scores, with no recurrent instability reported. Group A demonstrated slightly higher functional scores and range of motion. One patient in Group A experienced donor site pain, while one patient in Group B showed significant graft resorption. Graft union was achieved in all patients. Two-thirds of patients in each group returned to their pre-injury level of sports participation.

Conclusion: Both techniques provided good clinical outcomes for anterior shoulder instability with glenoid bone loss. The modified Latarjet with iliac crest graft may offer slight advantages in functional outcomes and graft preservation but is associated with potential donor site morbidity. Larger, prospective studies are needed to definitively compare these techniques.