title: What is a Bristow-Latarjet procedure? A review of the described operative techniques and outcomes.
abstract: OBJECTIVE
  A variety of operative techniques have been described as under the term 'Bristow-Latarjet' procedure. This review aims to define the original procedure, and compare the variation in techniques described in the literature, assessing any effect on clinical outcomes.
  
  
  METHODS
  A systematic review of 24 studies was performed to compare specific steps of the technique (coracoid osteotomy site, subscapularis approach, orientation and position of coracoid graft fixation and fixation method, additional labral and capsular repair) and detect any effect this variability had on outcomes.
  
  
  RESULTS
  Overall recurrence rate was 5.36% (2.94% to 43%). Half of the studies performed the procedure for recurrent shoulder instability, with only five studies documenting glenoid bone loss as an indication: 12 studies used the procedure as the primary surgical intervention for recurrent instability. No change in outcome was noted when examining variation in the coracoid osteotomy site, the fixation site on the scapular neck, the fixation method or whether a capsular repair was also performed. Performing a horizontal split in subscapularis may preserve external rotation compared with performing a tenotomy.
  
  
  CONCLUSIONS
  This is the first review to examine various operative techniques of the Bristow-Latarjet procedure, and their effect on outcome. We found that other than the approach through subscapularis, outcome was independent of the surgical technique, and depended more on patient selection. We would commend future publications on this procedure to provide a detailed description of the surgical technique, and as a minimum present rates of recurrence as an outcome measure. Cite this article: Bone Joint J 2016;98-B:1208-14.
authors: James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK.
authors: P D
authors: PD
authors: Cowling
authors: James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK.
authors: M A
authors: MA
authors: Akhtar
authors: James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK.
authors: R Y L
authors: RY
authors: Liow
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods; D001863:Bone Screws; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D010147:Pain Measurement; D018579:Patient Selection; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D012008:Recurrence; D018570:Risk Assessment; D012783:Shoulder Dislocation / Q000601:surgery*; D055815:Young Adult
keywords: Bristow-Latarjet; Shoulder instability