Michael-Alexander Malahias, Emmanouil Fandridis, Dimitrios Chytas, Efstathios Chronopulos, Emmanouil Brilakis, Emmanouil Antonogiannakis
PURPOSE: To investigate whether arthroscopic Latarjet procedure significantly differs from the open procedure as for the clinical, functional and radiographic outcomes.
METHODS: Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms "shoulder" AND "anterior" AND "instability" AND "Latarjet".
RESULTS: From the 259 initial papers, we finally assessed five clinical studies which were eligible to our inclusion-exclusion criteria. The mean modified Coleman score for methodological deficiencies of the studies was 65.4/100, whereas it ranged from 53/100 to 77/100. The arthroscopic technique illustrated comparable results to the open technique regarding the postoperative recurrence rate. No significant difference was found amongst groups in relation to the postoperative osteoarthritis, infection rates, soft tissue healing, postoperative mean American Shoulder and Elbow Surgeons score, mean Walch-Duplay score, fatty infiltration of the subscapularis muscle and posterior protrusion of the screw. The arthroscopic technique yielded significantly superior results as for the non-union rate of the graft, the total graft osteolysis and graft resorption, the mean Western Ontario Shoulder Instability Index score and the early postoperative pain.
CONCLUSIONS: Both the open and the arthroscopic Latarjet procedures led to satisfactory radiographic and clinical outcomes for the treatment of patients with recurrent anterior shoulder instability and significant glenoid bone loss. However, the overall quality of the studies ranged from low to moderate.
LEVEL OF EVIDENCE: Comprehensive and systematic review of level II-III therapeutic studies.
