Decision Making in the Treatment of Anteroinferior Shoulder Instability - Clinical and Radiological Variables

Purpose: To determine the clinical and radiological variables that are associated with the undertaking of the Latarjet procedure, rather than a Bankart procedure, for anteroinferior shoulder instability.Methods: Clinical and radiological (CT scan) data was evaluated retrospectively, on a cohort of 66 patients who had undergone surgery for recurrent anteroinferior, glenohumeral instability.Odds ratios (95%confidence intervals) were calculated for each variable to determine its association with performance of the Latarjet procedure as opposed to an arthroscopic soft-tissue reconstruction.Results: Linear glenoid bone loss and ipsilateral, previous stabilization surgery were the two variables demonstrated to be associated with a significantly higher likelihood of the patient undergoing a Latarjet procedure.Age at surgery, treating surgeon, and sports involvement were not associated with an increased likelihood of the patient undergoing a Latarjet procedure.Conclusion: None of the clinical parameters analyzed demonstrated an association with an increased likelihood of undergoing a Latarjet procedure for anteroinferior shoulder instability.Consistent with the published literature, we identified 19% linear glenoid bone loss as our cut-off for undertaking a Latarjet procedure for anteroinferior shoulder instability.