Treatment of recurrent anterior shoulder dislocation with Bristow-Latarjet procedure

Abstract

Objectives: To describe the clinical and radiographic results of patients with recurrent anterior shoulder dislocation treated with the Bristow-Latarjet technique. Material and Methods: Retrospective case series including 44 patients (45 shoulders) with anterior shoulder instability who underwent the Bristow-Latarjet procedure, including 86% of male patients and 80% with traumatic dislocations. The graft was fixed "standing", as used in the Bristow technique, in 84% of the shoulders, and "lying", as proposed by Latarjet, in 16%, using 1 metal screw in all cases, and washer in 20% of the surgeries. Results: The follow-up was 19.25 ± 10.24 months. We obtained 96% of good results, with 2 recurrences presented as subluxation. Of the 36 patients who practiced sports, 89% had good results. Graft healing occurred in 62% of cases. The graft was positioned below the glenoid equator in 84% of the cases, and less than 10 mm from its edge in 98%. The external rotation had a limitation of 20.7º ± 15.9º, while the internal rotation was limited in 4.0º ± 9.6º. The limitation of external and internal rotation and the position of the graft ("standing" or "lying") did not correlate with graft healing (p> 0.05). Bicortical fixation was positively correlated with healing (p <0.001). Conclusion: The Bristow-Latarjet technique is indicated for the treatment of recurrent anterior dislocations and subluxations of the shoulder. It is a safe treatment method, which can be used in people with intense physical activity. Limiting shoulder mobility does not prevent patients from returning to their usual occupations, as well as, in most of them, from playing sports with the same performance as before the surgery.

Level of evidence: IV, Case Series