# Recurrent Shoulder Instability With Glenoid Bone Loss: A Case Report on Congruent Arc Latarjet

## TL;DR

A case report shows the successful use of the congruent arc Latarjet procedure to treat severe shoulder instability caused by bone loss in a young athlete.

## Contribution

The report highlights the effectiveness of the congruent arc Latarjet procedure in complex cases with combined glenoid and humeral bone loss.

## Key findings

- The congruent arc Latarjet procedure restored stability in a patient with severe glenoid bone loss and Hill-Sachs lesion.
- Postoperative imaging confirmed proper placement of the coracoid graft and full pain-free motion at three months.
- Early recognition of bone loss and accurate imaging are critical for successful treatment outcomes.

## Abstract

Recurrent shoulder instability is challenging and is linked to significant bony defects such as glenoid bone loss and Hill-Sachs lesions (HSLs). The Latarjet procedure, particularly its congruent arc modification, provides a dependable solution for complex cases with combined glenoid and humeral bone loss. We report the case of a 23-year-old wrestler with recurrent left shoulder dislocations over seven years, severely impairing his daily activities. Clinically, there was a positive apprehension test and limited external rotation. Imaging showed a large HSL and an inverted pear-shaped glenoid, indicating marked bone loss. Glenoid track (GT) analysis confirmed an off-track lesion with high engagement risk. After diagnostic arthroscopy confirmed the bone loss, an open congruent arc Latarjet (CAL) procedure was performed via a deltopectoral approach. The coracoid graft was fixed with two parallel screws, and postoperative radiology verified proper placement. At three months, the patient regained full, pain-free motion without recurrence or functional limitation. This case highlights the importance of early bone loss recognition, accurate imaging, and meticulous planning. The CAL remains an effective option for restoring stability in high-demand patients.