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Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients

INTRODUCTION: The movement and steadiness of the shoulder joint is due to both the dynamic and static stabilisers. Recurrent anterior shoulder instability is common due to the Bankart lesion or the Hill Sachs lesion. The bone loss and soft tissue failure due to these lesions causing instability is w...

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Autores principales: Joshi, S, Rao, VKV, Shetty, UC, Rai, S, Arora, S, Kumar, SR
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Malaysian Orthopaedic Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381674/
https://www.ncbi.nlm.nih.gov/pubmed/34429836
http://dx.doi.org/10.5704/MOJ.2107.022
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author Joshi, S
Rao, VKV
Shetty, UC
Rai, S
Arora, S
Kumar, SR
author_facet Joshi, S
Rao, VKV
Shetty, UC
Rai, S
Arora, S
Kumar, SR
author_sort Joshi, S
collection PubMed
description INTRODUCTION: The movement and steadiness of the shoulder joint is due to both the dynamic and static stabilisers. Recurrent anterior shoulder instability is common due to the Bankart lesion or the Hill Sachs lesion. The bone loss and soft tissue failure due to these lesions causing instability is well compensated by Latarjet procedure which acts by triple blocking effect of the bone graft, the sling effect of the conjoint tendon of subscapularis and the ligament of the coracoacromial ligament stump. MATERIALS AND METHODS: Middle-aged patients with recurrent anterior shoulder dislocation and a mid-range instability on clinical assessment with an isolated glenoid bone loss of 20% or Bankart lesion with engaging Hill Sachs lesion were selected for the study. The surgical procedure included a subscapularis split to expose the glenoid. The coracoid graft harvested was prefixed with Kirschner wires and placed flush over the glenoid ensuring no medial or lateral overhang and fixed with 4.0mm cancellous screws with the washer. The functional outcome was measured with the ROWE score and ASES score and the movements were evaluated. RESULTS: A total of 24 patients fulfilled the inclusion criteria. Post-operatively at final follow-up, the mean ROWE score was 97.08 ±8.45 and the mean ASES score was 94.4±9.10. One patient had screw breakage as a complication and another had restriction of movement which was managed with physiotherapy. CONCLUSION: Open Latarjet is an effective procedure for recurrent anterior shoulder instability in non-athletic middle-aged patients as a excellent functional outcome was achieved with this technique. We therefore recommend open Latarjet as an alternative to arthroscopic treatment in developing countries where patient affordability and the availability of the resources are the issues.
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spelling pubmed-83816742021-08-23 Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients Joshi, S Rao, VKV Shetty, UC Rai, S Arora, S Kumar, SR Malays Orthop J Original Study INTRODUCTION: The movement and steadiness of the shoulder joint is due to both the dynamic and static stabilisers. Recurrent anterior shoulder instability is common due to the Bankart lesion or the Hill Sachs lesion. The bone loss and soft tissue failure due to these lesions causing instability is well compensated by Latarjet procedure which acts by triple blocking effect of the bone graft, the sling effect of the conjoint tendon of subscapularis and the ligament of the coracoacromial ligament stump. MATERIALS AND METHODS: Middle-aged patients with recurrent anterior shoulder dislocation and a mid-range instability on clinical assessment with an isolated glenoid bone loss of 20% or Bankart lesion with engaging Hill Sachs lesion were selected for the study. The surgical procedure included a subscapularis split to expose the glenoid. The coracoid graft harvested was prefixed with Kirschner wires and placed flush over the glenoid ensuring no medial or lateral overhang and fixed with 4.0mm cancellous screws with the washer. The functional outcome was measured with the ROWE score and ASES score and the movements were evaluated. RESULTS: A total of 24 patients fulfilled the inclusion criteria. Post-operatively at final follow-up, the mean ROWE score was 97.08 ±8.45 and the mean ASES score was 94.4±9.10. One patient had screw breakage as a complication and another had restriction of movement which was managed with physiotherapy. CONCLUSION: Open Latarjet is an effective procedure for recurrent anterior shoulder instability in non-athletic middle-aged patients as a excellent functional outcome was achieved with this technique. We therefore recommend open Latarjet as an alternative to arthroscopic treatment in developing countries where patient affordability and the availability of the resources are the issues. Malaysian Orthopaedic Association 2021-07 /pmc/articles/PMC8381674/ /pubmed/34429836 http://dx.doi.org/10.5704/MOJ.2107.022 Text en © 2021 Malaysian Orthopaedic Association (MOA). All Rights Reserved https://creativecommons.org/licenses/by/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
spellingShingle Original Study
Joshi, S
Rao, VKV
Shetty, UC
Rai, S
Arora, S
Kumar, SR
Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients
title Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients
title_full Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients
title_fullStr Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients
title_full_unstemmed Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients
title_short Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients
title_sort functional outcome of open latarjet procedure in non-athletic middle-aged patients
topic Original Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381674/
https://www.ncbi.nlm.nih.gov/pubmed/34429836
http://dx.doi.org/10.5704/MOJ.2107.022
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