Arthroscopic versus open Latarjet: a step-by-step comprehensive and systematic review
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GENERAL REVIEW • SHOULDER - ARTHROSCOPY
Arthroscopic versus open Latarjet: a step‑by‑step comprehensive and systematic review Michael‑Alexander Malahias1 · Emmanouil Fandridis2 · Dimitrios Chytas3 · Efstathios Chronopulos3 · Emmanouil Brilakis1 · Emmanouil Antonogiannakis1 Received: 31 August 2018 / Accepted: 9 February 2019 © Springer-Verlag France SAS, part of Springer Nature 2019
Abstract Purpose To investigate whether arthroscopic Latarjet procedure significantly differs from the open procedure as for the clinical, functional and radiographic outcomes. Methods Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “shoulder” AND “anterior” AND “instability” AND “Latarjet”. Results From the 259 initial papers, we finally assessed five clinical studies which were eligible to our inclusion–exclusion criteria. The mean modified Coleman score for methodological deficiencies of the studies was 65.4/100, whereas it ranged from 53/100 to 77/100. The arthroscopic technique illustrated comparable results to the open technique regarding the postoperative recurrence rate. No significant difference was found amongst groups in relation to the postoperative osteoarthritis, infection rates, soft tissue healing, postoperative mean American Shoulder and Elbow Surgeons score, mean Walch–Duplay score, fatty infiltration of the subscapularis muscle and posterior protrusion of the screw. The arthroscopic technique yielded significantly superior results as for the non-union rate of the graft, the total graft osteolysis and graft resorption, the mean Western Ontario Shoulder Instability Index score and the early postoperative pain. Conclusions Both the open and the arthroscopic Latarjet procedures led to satisfactory radiographic and clinical outcomes for the treatment of patients with recurrent anterior shoulder instability and significant glenoid bone loss. However, the overall quality of the studies ranged from low to moderate. Level of evidence Comprehensive and systematic review of level II–III therapeutic studies. Keywords Arthroscopic Latarjet · Bristow–Latarjet · Bone block procedures · Glenoid bone loss · Recurrent shoulder instability · Open versus arthroscopic Latarjet
Introduction In 1954, Latarjet described his treatment for recurrent dislocation of shoulder by transposing the coracoid process on the neck of the scapula and securing it with a screw [1]. The * Michael‑Alexander Malahias [email protected] 1
3rd Orthopaedic Department, Hygeia Hospital, Erythrou Stavrou 4, Marousi, 15123 Athens, Greece
2
Hand‑Upper Limb and Microsurgery Department, Hospital KAT, Athens, Greece
3
2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Agias Olgas 3, Nea Ionia, 14233 Athens, Greece
following steps were usually followed: coracoid preparation and o
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