Description
Purpose: Glenoid defect orientation (GDO) differs between patients with anterior shoulder instability. We apply Latarjet procedure in patients with a large glenoid bone loss or young collision athletes. However, it is unknown whether the different GDO affects clinical results after Latarjet procedure. This study aimed to clarify the influence of GDO on clinical outcomes after open Latarjet procedure combined with arthroscopic Bankart repair (aB&oL).
Method: A total of 19 shoulders with a glenoid bone loss underwent aB&oL were investigated. Preoperative GDO and postoperative clinical outcomes (JSS-SIS score, Rowe score, WOSI index, apprehensive feeling, and recurrence) at 1 year and final follow-up were evaluated. GDO was classified as antero-superior (AS) group, or antero-inferior (AI) group based on the inclination of the line perpendicular to line connecting the superior and inferior edges of the bone defect.
Result: Ten shoulders were categorized as an AS type, while remaining 9 shoulders as an AI type. At 1 year postoperatively, Rowe score and WOSI index were significantly better in AI group than AS group (AS: 85.0 vs AI: 92.2, p=0.003, AS: 444 vs AI: 98, p=0.04, respectively). Although there were no significant differences, apprehensive feeling was only recognized in 9.0% of AS group. No recurrence was observed in both groups.
Conclusion: Clinical scores at 1 year postoperatively of Latarjet surgery combined with arthroscopic Bankart repair were inferior in cases with an antero-superior oriented defect compared to those with an antero-inferior defect. The Latarjet procedure for cases with an antero-superior oriented glenoid defect might be associated with a slightly inferior performance in the early stage after the operation.
