title: Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review.
abstract: BACKGROUND
  To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability.
  
  
  METHODS
  Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography.
  
  
  RESULTS
  Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p < 0.01) and 10° (p < 0.001), respectively. Subjective shoulder function was good. Mean (SD) scores on the WOSI, MISS and l'Insalata scales were 78.0 (19.7), 75.8 (11.5) and 89.3 (9.9), respectively. No loss of subscapularis strength was identified (p > 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm(2) reconstituted surgically by a bone block of 225.4 (73.8) mm(2). Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p < 0.05).
  
  
  CONCLUSIONS
  The Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy.
authors: Melbourne Orthopaedic Group, The Avenue Hospital, Windsor, Australia.
authors: Devinder
authors: D
authors: Garewal
authors: Melbourne Orthopaedic Group, The Avenue Hospital, Windsor, Australia.
authors: Mathew
authors: M
authors: Evans
authors: Emergency Department, Austin Health, Heidelberg, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia.
authors: David
authors: D
authors: Taylor
authors: Melbourne Orthopaedic Group, The Avenue Hospital, Windsor, Australia.
authors: Gregory A
authors: GA
authors: Hoy
authors: Melbourne Orthopaedic Group, The Avenue Hospital, Windsor, Australia.
authors: Shane
authors: S
authors: Barwood
authors: Department of Medicine, Nursing and Healthcare, Monash University, Melbourne, Australia.
authors: David
authors: D
authors: Connell
keywords: Latarjet; function; instability; shoulder; subscapularis