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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 April;64(2):183-93
Functional and radiological results of modified Bristow-Latarjet procedure for anterior shoulder instability
Canbora M. K. 1, Kose O. 2, Polat A. 1, Konukoglu L. 1, Gorgec M. 1, Guler F. 2 ✉
1 Haydarpasa Numune Education and Research Hospital Orthopaedics and Traumatology Clinic Istanbul, Turkey;
2 Antalya Education and Research Hospital Orthoapedics and Traumatology Clinic Antalya, Turkey
Aim: The purpose of this study was to present the functional and radiological results of eighteen patients with anterior shoulder instability who were treated with modified Bristow-Latarjet procedure, and analyse the relationship between coracoids graft problems with functional results.
Methods: The study comprised 18 cases treated with the modified Bristow-Latarjet technique and followed-up for a mean 28.3 months between 2006 and 2011. Patients were clinically rated with Rowe instability score and visual analogue scale (VAS). Radiologic evaluations of the coracoid graft regarding its position, union, condition, and lysis were performed with plain radiographs and computerized tomography. Any complication during the follow-up was recorded.
Results: Postoperative Rowe instability scores were excellent or good in 77% of cases. Restriction was determined in anterior flexion in 12 cases (66.6%), and in external rotation in 14 cases (77.7%). Coracoid graft placement was determined to be appropriate in 14 cases (77.7%) and inappropriate in 4 cases (22.3%). In three cases, there was coracoid graft nonunion associated with fracture or lysis. In one case there was migration of the graft and three cases had persistent subluxation. There was suprascapular nerve irritation due to the screws that had to be extracted in one case. One case required further revision surgery due to lysis and loosening in the graft. Redislocation was not observed in any case.
Conclusion: Modified Bristow-Latarjet technique provides effective stability in recurrent anterior shoulder instability. However, particularly when accompanied by laxity, there is a negative effect on coracoid graft complication rates. The coracoid graft should be evaluated carefully when there is postoperative subluxation.