ArticleJSES international2025
Arthroscopic Latarjet combined with remplissage and capsulolabral repair in the treatment of anterior shoulder instability-the quadruple effect. A prospective study of functional outcome in patients with 2-year follow-up.
Article in JSES international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Latarjet procedure is largely considered a successful procedure, however, evidenced by a nonnegligible failure rate in terms of residual apprehension, and subtle or frank instability. Despite conferring a triple block effect (improving glenoid width, capsulolabral repair and sling effect of split subscapularis), the procedure, however, fails to address Hill Sach's defect. Recent research on bipolar bone lesions in the setting of anterior instability has revealed the propensity of Latarjet to fail in the presence of larger Hill Sach lesions, which have higher chances of engagement of the anterior glenoid rim, emphasizing the need to treat these humeral bone defects. To this effect, remplissage has had a proven track record in combination with Bankart repair. Methods: The functional and clinical outcomes of patients having undergone arthroscopic Latarjet with remplissage with a minimum of 2 years and secondarily, the external rotation was assessed postoperatively. Results: In a total of 40 patients, there was a significant improvement in American Shoulder and Elbow Surgeons, Western Ontario Shoulder Index, and Rowe scores {Western Ontario Shoulder Index (1379/186.5), Rowe (19.69/91.41) and American Shoulder and Elbow Surgeons (44.5/93)} and external rotation. Visual analog score reduced significantly (6 - preoperative to 1 - postoperative). Though an external rotation deficit was observed, when compared to the opposite shoulder, the patients did not have any functional deficits in performing daily activities. Conclusion: Arthroscopic Latarjet combined with capsulolabral repair and remplissage yields good clinical and functional outcomes with no residual apprehension or instability recurrence in treating recurrent anterior instability at a 2-year minimum follow-up. The limitation of external rotation is minimal and clinically insignificant.
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