Outcomes of the Latarjet procedure for the treatment of anterior shoulder instability at Bonassama district hospital

Abstract

Background: Anterior shoulder instability, common in young, active individuals, often recurs and impairs function. The Latarjet procedure is a gold standard for managing recurrent instability with significant glenoid bone loss. This study evaluates its short-and medium-term outcomes at Bonassama District Hospital, focusing on stability and complications. Methodology: This prospective, descriptive study was conducted from June 2020 to June 2024, including 11 patients who underwent the open Latarjet procedure for recurrent anterior shoulder instability. The surgical technique involved a deltopectoral approach, harvesting the coracoid process, and fixing it to the anteroinferior glenoid rim using two 30-45 mm malleolar screws. Functional outcomes were assessed using the Rowe, Walch-Duplay, and WOSI scores, while radiological outcomes evaluated graft positioning and complications such as osteoarthritis. Follow-up lasted an average of 28 months, with regular clinical and radiological evaluations. Results: The study population had a mean age of 25.63 years (range: 17-34 years), with 90.9% being male and 54.5% presenting right shoulder involvement. Functional scores significantly improved postoperatively: the Rowe score increased from 45±5 to 88±6, and the WOSI score decreased from 1500±200 to 208±50. Radiological evaluation revealed proper graft positioning in 81.8% of cases, with 100% consolidation and no graft migration. One patient (9.1%) developed mild glenohumeral osteoarthritis (Samilson stage I). No cases of recurrence, infection, or neurovascular complications were observed. The primary causes of instability were traumatic in 90.9% of patients, primarily due to accidents (63.6%) and falls (27.3%). Conclusion: The Latarjet procedure demonstrated excellent functional and anatomical outcomes in this cohort, with significant improvements in shoulder stability and quality of life. Postoperative complications were minimal, and no recurrences were observed, highlighting the effectiveness and safety of the procedure in managing anterior shoulder instability. These findings align with international standards, reinforcing the validity of the Latarjet technique in a local context. However, further studies with larger sample sizes and longer follow-up are needed to evaluate long-term outcomes.