Background: The original Latarjet-Patte procedure is a reliable technique to treat traumatic anterior shoulder instability. However, attempts to reduce possible complications have led to the emergence of modified techniques. More prominent among them are the arthroscopic approach and the use of cortical buttons for coracoid fixation. To date, limited research is available directly comparing the simultaneous use of these 2 modifications to the original Latarjet-Patte technique. The purpose of this article is to compare clinical and radiologic outcomes and complications between open Latarjet with screws and arthroscopic Latarjet with cortical buttons for traumatic anterior shoulder instability.
Methods: A multicenter retrospective cohort study was performed of medical records and imaging studies of 2 groups of patients, with 2 years of follow-up, who underwent either one of 2 variations of the Latarjet procedure: open approach with screws (open-screw group) or arthroscopic approach with cortical buttons (scope-button group). Group homogenization was ensured by statistical comparison of 14 baseline independent variables as well as multiple regression analysis to assess confounding factors. The primary outcome was the Rowe score at 24 months after surgery, for which the minimal clinically important difference of 9.7 points was used. Secondary outcomes were recurrence of instability, graft positioning, the Rowe score at other points in time, and complications.
Results: Thirty-eight patients were evaluated in the open-screw group and 44 in the scope-button group, with a 24-month follow-up. All but 1 patient in each group achieved the minimal clinically important difference from pre- to postoperative Rowe score. The Rowe score did not differ between groups during any of the assessment times. There was no difference regarding graft vertical (P = .620) or horizontal (P = .280) positioning. There was 1 recurrence in each group: a dislocation in the open-screw group (P = .463) and a subluxation in the scope-button group (P > .999). Other complications happened exclusively in the scope-button group: neuropraxia (n = 1; P > .999), infection (n = 2; P > .999), graft fracture (n = 1; P > .999), and graft migration (n = 2; P > .999). Multiple regression analysis did not observe influence from any of the potential confounding factors on the final results.
Conclusion: At early follow-up, arthroscopic Latarjet with cortical buttons yielded comparably good clinical and radiologic results to the conventional open Latarjet with screws.
Keywords: Arthroscopy; Latarjet; buttons; fixation; instability; screws; shoulder.
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