# Shoulder ligamentoplasty, arthroscopic Latarjet, dynamic anterior stabilization, and arthroscopic Trillat for the treatment of shoulder instability: a systematic review of original studies on surgical techniques

## TL;DR

This paper reviews various surgical techniques for treating shoulder instability, comparing their benefits and suitability based on patient-specific factors.

## Contribution

The study systematically evaluates four surgical techniques for shoulder instability, highlighting their unique advantages and clinical applications.

## Key findings

- Arthroscopic ligamentoplasty preserves native anatomy and allows alternative interventions if needed.
- The Latarjet procedure is recommended for significant bone loss in shoulder instability.
- Dynamic anterior stabilization uses the biceps tendon to provide dynamic joint support.

## Abstract

Anterior shoulder instability is a common condition, especially among young and active individuals, often associated with both osseous and soft tissue injuries. Recent innovations have introduced various surgical options for managing critical and subcritical instability. Therefore, the primary objective of this systematic review was to collect, synthesize, and integrate international research published across multiple scientific databases on shoulder ligamentoplasty, arthroscopic Latarjet, dynamic anterior stabilization (DAS), and arthroscopic Trillat techniques used in the treatment of shoulder instability.

A structured search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PICOS model, up to January 30, 2025, in the MEDLINE/PubMed, Web of Science (WOS), ScienceDirect, Cochrane Library, SciELO, EMBASE, SPORTDiscus, and Scopus databases. The risk of bias was evaluated, and the PEDro scale was used to assess methodological quality.

The initial search yielded a total of 964 articles. After applying the inclusion and exclusion criteria, the final sample consisted of 25 articles. These studies demonstrated a high standard of methodological quality. The review summarized the effects of ligamentoplasty, arthroscopic Latarjet, dynamic anterior stabilization, and arthroscopic Trillat techniques in treating shoulder instability, detailing the sample population, immobilization period, frequency of instability episodes—including recurrent dislocations and subluxations—surgical methods, study designs, assessed variables, main findings, and reported outcomes.

Arthroscopic ligamentoplasty is advantageous in preserving the patient’s native anatomy, maintaining joint integrity, and allowing for alternative interventions in case of failure. The arthroscopic Trillat technique offers a minimally invasive solution for anterior instability without significant bone loss. The DAS technique utilizes the biceps tendon to provide dynamic stabilization, aiming to generate a sling effect over the subscapularis muscle. The Latarjet procedure remains the gold standard for managing anterior glenoid bone loss greater than 20%. Each surgical option for anterior shoulder instability carries specific implications, and treatment decisions should be tailored based on bone loss severity, capsuloligamentous quality, and the patient’s functional needs.