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. 2025 Jun;20(2):289-295.
doi: 10.26574/maedica.2025.20.2.289.

Functional and Radiological Outcomes of Open Versus Arthroscopic Latarjet for Anterior Shoulder Instability

Christos Koukos  1   2 , Georgia Kanellopoulou  3 , Dimitrios Giotis  4 , Christos Yiannakopoulos  5 , Stylianos Kapetanakis  6 , Christos Konstantinidis  4 , Saseendar Shanmugasundaram  7 , Emilios E Pakos  8 , Koray Sahin  9 , Fredy Montoya  10
Affiliations

Functional and Radiological Outcomes of Open Versus Arthroscopic Latarjet for Anterior Shoulder Instability

Christos Koukos et al. Maedica (Bucur). 2025 Jun.

Abstract

Objectives: The purpose of this study is to compare the clinical, functional and radiographic outcomes among 42 patients with anterior shoulder instability treated with either the open or arthroscopic Latarjet procedure.

Materials and methods: Between 2011 and 2018, we treated 42 patients with anterior shoulder instability, 19 underwent the open Latarjet procedure (OLP) and 23 underwent the arthroscopic Latarjet procedure (ALP). In the OLP group, 17 patients were males, with a mean age of 21.3 years (range: 16-37 years ) and a mean follow-up of 6.2 years (range: 5.5-7.2 years). In the ALP group, 20 patients were males, with a mean age of 20.6 years (range: 17-31 years) and a mean follow-up of 2.5 years (range: 2-3.1 years). All procedures were performed by a single surgeon. Functional outcomes were assessed using the University of California-Los Angeles (UCLA) shoulder score and the constant score (CS). Radiographic evaluations included standard radiographs and computed tomography (CT) scans. The two groups were compared to analyze differences in outcomes.

Results: All patients returned to their pre-injury level of activity. The arthroscopic Latarjet procedure resulted in better graft integration and inferior screw positioning. No major complications were reported in either group.

Conclusions: Anterior shoulder instability remains a complex issue in orthopedics regarding the optimal management approach. However, this study suggests that the arthroscopic Latarjet procedure offers advantages, including superior visualization and effective restoration of damage.

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Conflict of interest statement

None declared.

Figures

FIGURE 1.
FIGURE 1.
Graft position in coronal plane. In coronal computed tomography (CT) plane, 3D reconstruction of the glenoid, defining the glenoid superior-inferior length (black line) and the equator (red line). The graft, as shown inferior-anterior, is adequate when it is under the glenoid equator.
FIGURE 2.
FIGURE 2.
Graft position in axial plane. In axial computed tomography (CT) plane, measurement of the distance between graft and glenoid surface. Distance is characterized as adequate when it is 2-5 mm.
FIGURE 3.
FIGURE 3.
Divergence of the angle of both inferior and superior screws. In axial computed tomography (CT) plane, assessing the divergence of the inferior and superior screw (yellow arc). Divergence is defined as the angle between the screw and the articular surface (in this picture we measure the inferior screw’s divergence).
FIGURE 4.
FIGURE 4.
Bar chart displaying inferior screw divergence in the open Latarjet procedure (OLP) (blue bars) and arthroscopic Latarjet procedure (ALP) (green bars). The ALP group demonstrates a significantly higher proportion of screws positioned within the optimal 10-15° range compared to the OLP group.
FIGURE 5.
FIGURE 5.
Bar chart exhibiting graft integration outcomes in the open Latarjet procedure (OLP) (blue bars) and arthroscopic Latarjet procedure (ALP) (green bars). The ALP group shows a higher rate of complete graft integration (>75%), while the OLP group has a greater incidence of graft fragmentation.
See this image and copyright information in PMC

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