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International Orthopaedics

, Volume 43, Issue 8, pp 1899–1907 | Cite as

Analysis of failures after the Bristow-Latarjet procedure for recurrent shoulder instability

  • Laurent WillemotEmail author
  • Sara De Boey
  • Alexander Van Tongel
  • Geert Declercq
  • Lieven De Wilde
  • Olivier Verborgt
Original Paper

Abstract

Purpose

Despite good clinical results and low recurrence rates, post-operative complications of coracoid process transfer procedures are not well understood. This study aims to evaluate the underlying failure mechanism in cases requiring major open revision surgery after prior Bristow or Latarjet stabilization.

Methods

Between January 2006 and January 2017, 26 patients underwent major open revision after primary Bristow or Latarjet procedure. Clinical notes and radiographic images were retrospectively reviewed for all cases to determine underlying pathology. Choice of treatment and clinical and radiographic outcome were similarly reported for all cases.

Results

The underlying failure mechanism was associated with non-union in 42.3%, resorption in 23.1%, graft malpositioning in 15.4%, and trauma or graft fracture in 19.2% of cases. Although none of the patients reported any dislocations, mean subjective shoulder score was 60.2% and WOSI scores averaged 709.3 points at final follow-up. Radiographic signs of deteriorating degenerative arthritis were seen in 34.6%.

Conclusion

Graft non-union resulting in recurrent instability was the main indication for open revision surgery after Bristow or Latarjet procedure, followed by resorption, malpositioning, and graft fracture in this retrospective case series. Revision surgery consisted of a structural iliac crest bone graft in the majority of cases. Clinical and radiographic outcomes are predictably variable in this population of multioperated patients.

Keywords

Glenohumeral instability Bristow-Latarjet Coracoid transfer Complications Revision 

Notes

Acknowledgements

We would like to thank Kristien Vuylsteke for her help in data collection and patient follow-up and Nicole Declerck for helping with the anatomic drawings.

Compliance with ethical standards

Ethical Review Board approval was granted to conduct this retropective study (ED/2014/0060) in compliance with ethical standards.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Laurent Willemot
    • 1
    Email author
  • Sara De Boey
    • 1
  • Alexander Van Tongel
    • 1
  • Geert Declercq
    • 2
  • Lieven De Wilde
    • 1
  • Olivier Verborgt
    • 2
  1. 1.Department of Orthopaedic Surgery and TraumatologyUniversity Hospital GhentGhentBelgium
  2. 2.Department of Orthopaedic Surgery and TraumatologyAZ MonicaAntwerpBelgium

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