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Latarjet procedure, iliac crest bone graft transfer for shoulder instability yield similar outcomes
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According to recently published results, there was no difference seen in clinical and radiologic outcomes with the Latarjet procedure and iliac crest bone graft transfer procedure. However, patients who underwent the Latarjet procedure had worse internal rotation capacity. Frequent donor-site sensory disturbances were seen with the iliac crest bone graft transfer procedure.
Researchers randomly assigned 60 patients with anterior shoulder instability and glenoid bone loss to either an open Latarjet procedure or an open iliac crest bone graft transfer procedure. Before surgery and at 6, 12 and 24 months postoperatively, clinical evaluations – including Western Ontario Shoulder Instability index, Rowe score, subjective Shoulder Value, pain level, satisfaction level, and work and sports impairment – and instability, range of motion, and strength were performed. Preoperative and postoperative radiographs were performed as well as a follow-up CT analysis.
Results showed clinical scores were not significantly different between the treatment groups. At every follow-up point, there was no significant difference in strength and range of motion between groups apart from the diminished internal rotation capacity seen in patients who underwent the Latarjet procedure. Two patients underwent iliac crest bone graft transfer procedure and one patient who underwent Latarjet procedure with postoperative traumatic subluxation. The severity of other events and the type of adverse events were different between the groups. Donor-site sensory disturbance were seen in 27% of patient who underwent iliac crest bone graft transfer procedure.
According to results from the CT scans, there was a larger glenoid augmentation effect seen in patients who underwent the iliac crest bone graft transfer procedure. However, this decreased at the follow-up. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
Editor's Note: On August 12, 2019, the article was corrected to add clarity to the results about patients who underwent the Latarjet procedure vs. the iliac crest bone graft transfer procedure. The editors regret this error.
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