Congruent Arc Latarjet with Subscapularis Split in Patients with Shoulder Instability and Hill Sachs Lesions: Functional Outcome at 2-Year Follow-Up

Introduction: Shoulder dislocations are the most frequent of all dislocations in the body. Recurrence of shoulder dislocations is common in the younger age group with associated Bankart or Hill Sach’s lesions. Over 200 procedures have been described in the literature for the treatment of recurrent anterior dislocation of shoulder.

Aim of the study: We attempted to study the functional outcome of Congruent Arc Latarjet procedure in patients with recurrent anterior shoulder dislocations and associated Hill Sach’s lesions.

Materials and methods: Rowe score were used to assess the functional outcome in patients 45 patients (39 males and 6 females) with Hill Sach’s Lesions were enrolled. The minimum follow-up was 2 years. The mean preoperative Rowe score was 58.5+/-4.2. (Range 51 to 67 IQR=55). All patients had apprehension positivity. 30 patients (66%) had less than 10 dislocations while 15(33%) had more than 10 dislocations. Additional lesions present in these patients where soft tissue Bankart in 35 cases, 6 with glenoid bone loss, and 4 had only Bony Bankarts avulsions. Graft union was seen in 38 patients as evidenced by the Xray. Postoperatively, 5 patients (11%) had excellent results, 34 patients (75%) had good results, 2 (4%) had fair results and 4 (9%) had poor results. 4 patients had another episode of dislocation during the follow-up period. 8 patients (18%) had some degree of apprehension in abducted external rotation. All patients with excellent and good results were able to perform normal daily activities, engage in manual labor and recreational sports activities. There was mean external rotation loss of 20.5 with the arm in adduction and 15.0 with arm in abduction at 90 degrees on comparin g with the normal side.

Conclusion: Our study results show that the congruent arc Latarjet procedure with subscapularis split effectively stabilizes anterior shoulder instability in patients with Hill Sach’s Lesion.

Level of Evidence: IV: case series

Keywords: Congruent arc Latarjet; Recurrent dislocation shoulder; Hill Sach’s Lesion; Anterior shoulder instability; Latarjet procedure