LATARJET USING WEDGE PROFILE PLATE FOR FAILED BANKART's REPAIR

Coracoid fractures during screw insertion and graft osteolysis are serious concerns with standard screw fixation techniques in Latarjet procedure. This study tends to evaluate the outcome of mini open Latarjet using Arthrex mini-plate for coracoids graft fixation. We did retrospective analysis of 30 patients with recurrent anterior shoulder instability after arthroscopic Bankart9s repair. A low profile wedge plate (Arthrex) with two low profile screws was used for fixation of the coracoid graft. CT analysis was performed at final follow up to see graft union and results were evaluated using American shoulder and elbow score (ASES) and Western Ontario shoulder instability score (WOSIS). Mean follow up time was 24 months. Postoperatively, mean forward elevation was 162.8 degrees and external rotation was 44.6 degrees. All patients returned to their previous occupation. None reported to be having any recurrent subluxation post-surgery. The mean ASES score was 92.5 while the mean WOSIS score was 76.84%. Only one patient had screw backing out from the plate. There was no case of coracoid graft osteolysis. The mini-open Latarjet procedure with graft fixation with Arthrex mini-plate provides satisfactory outcome and stabilization in patients who present with dramatic bone loss and failed soft tissue reconstruction. It not only ensures early rehabilitation but also minimum loss of external rotation. The only drawback is the relatively high cost of the implant.