title: Preliminary clinical outcomes of Latarjet-Patte coracoid transfer by arthroscopy vs. open surgery: Prospective multicentre study of 390 cases.
abstract: The Latarjet-Patte procedure consisting in transfer and screw fixation of the coracoid process to the anterior glenoid is a treatment of reference for anterior shoulder instability. Over time, surgical innovations translated into a number of improvements and, in late 2003, an arthroscopically assisted variant of the procedure was described.
  
  
  
  To evaluate and compare clinical outcomes of the modified Latarjet-Patte procedure performed by open surgery, arthroscopy with screw fixation, or arthroscopy with endobutton fixation.
  
  
  
  A total of 390 patients who underwent surgery to treat anterior shoulder instability between March 2013 and June 2014 were included and divided into three groups depending on whether they were managed using open surgery with screw fixation, arthroscopy with screw fixation, or arthroscopy with endobutton fixation. Clinical findings were recorded pre-operatively then 6 months post-operatively and at last follow-up (mean, 27.7 months). Range of motion and apprehension test (arm in external rotation at 0°, 90°, and 140° of abduction) were assessed and the Walch-Duplay and modified Rowe scores were determined.
  
  
  
  Motion range restriction was minimal with all three techniques, and motion range continued to improve throughout follow-up. Apprehension in external rotation was noted at 90° of abduction in 11% of cases and at 140° of abduction in 4% of cases. The mean total Walch-Duplay score improved from 46 pre-operatively to 90.6 and the mean total modified Rowe score from 46 pre-operatively to 91.1. By statistical analysis, external rotation at 90° of abduction and internal rotation at 0° of abduction were better after open surgery, but the differences were of limited clinical significance. Recurrence was noted in 3.3% of cases, nerve injury in 0.8%, and infection in 1.5%.
  
  
  
  In this study, the three techniques produced similar clinical outcomes, with a stable shoulder and no joint stiffness.
authors: Hôpital privé La Châtaigneraie, 63110 Beaumont, France. Electronic address: pierremetais@mac.com.
authors: P
authors: P
authors: Metais
authors: Service de chirurgie du membre supérieur, avenue Baumann, 67400 Illkirch, France.
authors: P
authors: P
authors: Clavert
authors: Centre ostéo-articulaire des cèdres, 5, rue des Tropiques, 38130 Échirolles, France.
authors: J
authors: J
authors: Barth
authors: Institut universitaire locomoteur et du sport, CHU de Nice, 06000 Nice, France.
authors: P
authors: P
authors: Boileau
authors: St. Luke's Hospital, Bystrzanska 94b, 43-300 Bielsko-Biala, Poland.
authors: R
authors: R
authors: Brzoska
authors: Clinique des Maussins, 67, rue de Romainville, 75019 Paris, France.
authors: G
authors: G
authors: Nourissat
authors: Etzelclinic, Churerstrasse 43, 8808 Pfäffikon, Switzerland.
authors: J
authors: J
authors: Leuzinger
authors: Centre orthopédique Santy, hôpital privé J.-Mermoz (Ramsay-GDS), 24, avenue Paul-Santy, 69008 Lyon, France.
authors: G
authors: G
authors: Walch
authors: Clinique générale d'Annecy, 74000 Annecy, France.
authors: L
authors: L
authors: Lafosse
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001863:Bone Screws; D000070597:Coracoid Process / Q000637:transplantation*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012008:Recurrence; D012785:Shoulder Joint / Q000601:surgery*
keywords: Apprehension; Coracoid bone block; Range of motion; Scores; Techniques