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Open Latarjet may lead to better outcomes vs arthroscopic Latarjet
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ORLANDO — In a presentation at the Arthroscopy Association of North America Annual Meeting, Hannan Mullett, MCh, FRCSI (Tr&Orth), noted that the open Latarjet technique may lead to better outcomes and lower complications in collision athletes compared with an arthroscopic Latarjet technique.
In a meta-analysis of 896 patients, Mullett noted patients who underwent open Latarjet had a non-statistically significant trend toward better Rowe scores and outcomes for external rotation and total recurrent instability compared with arthroscopic Latarjet.
“The most concerning feature we discovered was that in the arthroscopic Latarjet, at least one-third of the patients will have persistent apprehension,” Mullett said in his presentation.
Although complications were not statistically significant, Mullett noted a trend toward a higher requirement for a revision procedure, as well as an increased number of neurological complications, in the arthroscopic Latarjet group. He added that open Latarjet provides more favorable screw and graft positioning in the medial/lateral and superior/inferior planes. The operative time for the arthroscopic Latarjet procedure was longer than the time for the open Latarjet, according to Mullett.
“This [operative time] comes closer to the open technique after a learning curve of 20 cases, but it remains significantly different,” Mullett said.
He also noted previously published research has shown the cost of performing arthroscopic Latarjet is 2.3-times greater than that of the open Latarjet technique.
“The arthroscopic Latarjet proponents often suggest that the cosmesis is better with the arthroscopic technique,” Mullett said. “One requires at least five and up to eight portals for some of these techniques and these often get conspicuous and often unattractive scars compared to the open technique.” – by Casey Tingle
Reference:
Mullett H. Scope vs. open latarjet. Presented at: Arthroscopy Association of North America Annual Meeting; May 2-4, 2019; Orlando.
Disclosure: Mullett reports no relevant financial disclosures.