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Latarjet-Patte Procedure Vs Modified Bristow-Latarjet Repair For Recurrent Anterior Dislocation Of The Shoulder. Our Experience In The Last 15 Years.

Latarjet-Patte Procedure Vs Modified Bristow-Latarjet Repair For Recurrent Anterior Dislocation Of The Shoulder. Our Experience In The Last 15 Years.

Maximiliano Ibañez, MD, SPAIN Marta Comas Aguilar, MD, SPAIN Maria Teresa Marlet Jordana, MD, SPAIN Lautaro Candioti Benassi, MD, SPAIN Victor Marlet Naranjo, MD, SPAIN Xavier Mir, SPAIN

ICATME - Dexeus University Hospital, Barcelona, Barcelona, SPAIN


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Summary: Clinical, functional, and radiographic outcomes of Latarjet-Patte procedure vs Modified Bristow-Latarjet repair for recurrent anterior dislocation of the shoulder in the last 15 years.


Aim

The purpose of this study was to compare the clinical, functional, and radiographic outcomes of Latarjet-Patte procedure vs Modified Bristow-Latarjet repair for recurrent anterior dislocation of the shoulder in the last 15 years.

Background

The glenohumeral joint is the most unstable articulation in the human body.
There are 2 different surgical approaches for shoulders with anterior instability: anatomic and nonanatomic. Among the nonanatomic are the Bristow - Latarjet and Latarjet-Patte procedures. The main differences between these techniques are the graft position (vertical for Latarjet and horizontal for Bristow), the number of screws (2 for Latarjet and 1 for Bristow), the subscapularis incision and the pectoralis minor detachment. In recent years some authors suggest the superiority of one procedure over the other.

Methods

Between January 2002 and December 2017 all patients treated with Latarjet-Patte procedure or Modified Bristow-Latarjet repair for recurrent anterior dislocation of the shoulder by three experienced shoulder surgeons were included in this retrospective cohort study. Range of motion, strength, QUICK-DASH, Constant Score, pain level according to the Visual Analog Scale (VAS) and Subjective Shoulder Value (SSV) were evaluated. In addition, complications, such as wound and deep infection, re-interventions and screw failure were evaluated.

Results

289 patients with a mean age of 46.8 years (range, 18-56 years) who 68 underwent Latarjet-Patte (n=68; group LP) and 221 Modified Bristow-Latarjet (n=221; group BL) were included in the study. The mean follow-up was 78 months (range, 24-180 months). At final follow-up there were no significant differences in Range of motion, strength, Constant Score, pain level according to the Visual Analog Scale (VAS) or Subjective Shoulder Value (SSV), all of them with p>0,05. Complications, such as wound and deep infection, re-interventions and screw failure were evaluated, being uncommon.

Conclusions

Good functional results were obtained following both Latarjet-Patte procedure and Modified Bristow-Latarjet repair procedures for the treatment of recurrent anterior dislocation of the shoulder..
Comparative analysis showed no statistically significant differences in Range of motion, strength, Constant Score, pain level according to the Visual Analog Scale (VAS) or Subjective Shoulder Value (SSV). Latarjet-Patte procedure and Modified Bristow-Latarjet techniques provide similar clinical and radiographic outcomes.


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