Does the Arthroscopic Latarjet Procedure Effectively Correct “Off-Track” Hill-Sachs Lesions?

Abstract

Background: The glenoid track concept describes the dynamic interaction of bipolar bone loss in anterior glenohumeral instability. Initial studies have successfully demonstrated this concept’s application in clinical populations. In clinical practice, the Latarjet procedure is commonly the preferred treatment in addressing “off-track” Hill-Sachs lesions. The effectiveness of this procedure in restoring such lesions to an “on-track” state, however, has not yet been evaluated or described in the literature. Hypothesis: The Latarjet procedure would transform “off-track” Hill-Sachs lesions to “on-track” lesions. Lesions would remain “on-track” during follow-up, despite glenoid remodeling. Study Design: Case series; Level of evidence, 4. Methods: Patients with “off-track” Hill-Sachs lesions treated with the arthroscopic Latarjet procedure between March 2013 and May 2014 were included. Glenoid track and coracoid graft contact surface area measurements using 3-dimensional computed tomography (3D-CT) were performed preoperatively and at 6-week, 6-month, and at least 12-month (final) follow-up. The mean final follow-up was 23 months. The glenoid diameter, as a percentage of the native glenoid, was also calculated from this imaging. Results: Twenty-six patients met the inclusion criteria. 3D-CT scans were available for all patients preoperatively and postoperatively, with 21 patients (81%) undergoing 6-month follow-up CT and 19 patients (73%) undergoing final follow-up CT. Hill-Sachs lesions remained “on-track” at all follow-up time points. The mean glenoid diameter changed significantly from 84.6% preoperatively to 122.8% at 6 weeks (P