These authors sought to describe the rate and type of complications occurring within 90 days following the Latarjet procedure for anterior glenohumeral instability. They reviewed consecutive patients undergoing the Latarjet procedure by fellowship-trained surgeons from a single institution between 2007 and 2016 were included for analysis. Their indications for the Latarjet procedure included primary or recurrent anterior instability with clinically significant anterior glenoid bone loss and/or failed prior arthroscopic stabilization. Patients undergoing the Latarjet procedure after prior glenoid bone grafting were excluded.
Among 133 patients (average age, 28.5 ± 11.8 years; 75% male patients), 10 total complications occurred within 90 days of surgery, for an overall short-term complication rate of 7.5%. Of these 10 complications, 6 required subsequent surgery, with recurrent instability in 2 cases (overall rate, 1.50%), infection in 2 (overall rate, 1.50%), musculocutaneous nerve palsy in 1 (overall rate, 0.75%), and postoperative pain in 1 (overall rate, 0.75%).
Each of the 2 patients who experienced recurrent subluxation events ultimately required conversion to arthroplasty. The 2 patients with infections underwent subsequent irrigation and débridement, as well as antibiotic therapy. The patient with the musculocutaneous nerve injury ultimately required further surgery in the form of a musculocutaneous nerve decompression and subsequent nerve transfer procedure. The remaining 4 complications were transient and resolved with nonoperative treatment, including wound dehiscence, hematoma, complex regional pain syndrome, and ulnar neuritis.
Comment: An increasing number of surgeons are being attracted to the Latarjet procedure for patients both without and with glenoid bone deficiencies. This article concerns the Latarjet complications in a single institution with highly trained shoulder surgeons - their report is likely to underrepresent the nature and frequency of Latarjet complications in the hands of community surgeons.
It is to be noted that this study of 90 day complications would not capture the longer term complications of this procedure, such as screw loosening, coracoid non-union, and capsulorrhaphy arthropathy. Their article did show one case of arthritis related to contact of the fixation screw with the humeral head.
In our practice we have been referred a number of patients with hardware problems after the Latarjet procedure; some performed on shoulders without glenoid bone deficiency.
Here are some examples:
Patients and surgeons considering the Latarjet procedure should be aware of these potential complications as well as the difficulties associated with revision surgery in patients with a failed Latarjet (subscapularis scarring/deficiency, altered surgical anatomy, glenoid bone deficiency, nerve entrapment).
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Here are some examples:
Patients and surgeons considering the Latarjet procedure should be aware of these potential complications as well as the difficulties associated with revision surgery in patients with a failed Latarjet (subscapularis scarring/deficiency, altered surgical anatomy, glenoid bone deficiency, nerve entrapment).
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