Arthroscopy - 2026-04-22 - Journal Article
Arthroscopic Latarjet Procedure With Anterior Capsular Reconstruction Provides Low Rates of Recurrence and Osteoarthritis at Minimum 5-Year Follow-Up.
Zhang D, Li P, Qin Q, Jiang C, Zhu Y
Topics
Key Takeaway
Arthroscopic Latarjet with anterior capsular reconstruction achieved 0% recurrent dislocation and 97.7% coracoid union at mean 7.1-year follow-up, with grade II subscapularis fatty infiltration independently predicting OA progression (OR 45.0).
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Summary
This retrospective case series evaluated 44 patients undergoing modified arthroscopic Latarjet with anterior capsular reconstruction for recurrent anterior shoulder instability at minimum 5-year follow-up. All functional scores improved significantly (Rowe: 40 to 91.6, p<0.0001; ASES: 90.0 to 99.0, p=0.0002), 100% of patients returned to sport, and zero recurrent dislocations or subluxations occurred. OA progressed in 20.5% of cases, but only 4.5% reached grade III; grade II subscapularis fatty infiltration was the sole independent predictor of OA progression (OR 45.0, p=0.017).
Key Limitation
31% loss to follow-up (20/64 patients excluded) with no reported comparison between included and excluded patients creates substantial selection bias that limits generalizability of the zero-recurrence finding.
Original Abstract
PURPOSE
To evaluate the clinical outcomes and radiographic findings associated with the modified arthroscopic Latarjet procedure after a minimum 5-year follow-up.
METHODS
Patients with recurrent anterior shoulder instability who underwent a modified arthroscopic Latarjet procedure with anterior capsule reconstruction between March 2015 and December 2017 were systematically followed from January 2023 to June 2024. The minimum follow-up duration was 5 years. Clinical evaluations included the American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM), and Rowe scores, as well as assessment of range-of-motion (ROM) and rate of return to sports (RTS). X-ray and computed tomography (CT) imaging were used to evaluate graft union, progression of osteoarthritis (OA), and fatty infiltration (FI) of the subscapularis muscle. Statistical analyses included comparisons of pre- and postoperation measures, correlation analyses (Pearson's/Spearman's), and binary logistic regression for OA progression.
RESULTS
Of the 64 consecutive patients who underwent modified arthroscopic Latarjet procedure, 44 (mean age at operation, 32.2 ± 8.7 years; range, 19-54 years) were included in the final analysis, with a mean follow-up of 7.1 ± 1.4 years (range, 60-105 months). At final follow-up, no patient experienced recurrent shoulder dislocation or subluxation. Functional scores improved significantly compared with preoperative values (ASES: 90.0 (85.0-94.6) to 99.0 (95.0-100.0), P = .0002; CM:84.1 ± 8.5 to 94.0 (91.0-97.0), P < .0001;
ROWE
40.0 (35.0-45.0) to 91.6 ± 10.6, P < .0001). Twenty-six patients (59.1%) achieved the minimal clinically important difference for the ASES (6.4), 29 patients (65.9%) for the CM (4.6), and all patients (100%) for the Rowe score (4.4). No significant restriction in range of motion was observed (forward elevation: 170° (160.0°-180.0°) to 160.2°± 11.8°, P = .109; external rotation: 60° (60.0°-60.0°) to 54.3°± 13.2°, P = .140; internal rotation: T9 to T8, P = .533). All patients returned to sports, with 61.4% resuming play at or above their preinjury level or higher. One patient required removal of the proximal screw. Coracoid bone union was achieved in 43 cases (97.7%). FI of the subscapularis muscle was observed in 34 cases (77.3%), including grade I in 27 cases (61.4%) and grade II in 7 cases (15.9%). Radiographic evaluation showed OA progressed in 9 cases (20.5%), including progression from grade 0 to I in 7 cases (15.9%) and from grade 0 to grade III in 2 cases (4.5%). Grade I OA did not affect shoulder function. Binary logistic regression analysis revealed that high-grade (grade II) FI of the subscapularis muscle at the final follow-up significantly associated with OA progression (P = .017, OR = 45.014).
CONCLUSIONS
The arthroscopic Latarjet procedure with anterior capsular reconstruction showed favorable clinical and radiological outcomes after a minimum 5-year follow-up. Patients showed significant improvements in patient-reported measures, high rates of RTS, and no recurrent dislocation or subluxation. Satisfactory positioning of the coracoid graft and high rates of bone union were achieved. A low rate of severe OA progression was observed. Analysis of the limited number of cases with OA progression in this series suggested that the degree of postoperative FI of the subscapularis muscle may be associated with the extent of OA progression.
LEVEL OF EVIDENCE
Level IV, retrospective case series.