TechniquesLatarjet-Patte Triple-locking Procedure for Recurrent Anterior InstabilityHolzer, Nicolas A. MD, PhD*; Cunningham, Gregory MD*; Ladermann, Alexandre MD*,†,‡; Gazielly, Dominique MD*,§Author Information *Department of Surgery, Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals †Faculty of Medicine, University of Geneva, Geneva ‡Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin §Division of Orthopaedics and Trauma Surgery, Genolier Hospital, Genolier, Switzerland The authors declare no conflict of interest. Reprints: Nicolas A. Holzer, MD, PhD, Department of Surgery, Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland (e-mail: [email protected]). Techniques in Shoulder & Elbow Surgery: September 2013 - Volume 14 - Issue 3 - p 63-68 doi: 10.1097/BTE.0b013e3182961957 Buy Metrics Abstract Indication to perform an anterior glenoid augmentation by means of a coracoid bone graft in the setting of anterior instability in particular subsets of patients emerges as a new standard of care. Surgical techniques originally described by Latarjet and Helfet were modified by Patte in 1980. The coracoid graft is lying in supine position held in place by a single screw. Systematic capsular retensioning adds a capsular lock to the classical bone block and sling effect of the Latarjet technique. We hypothesized that systematic capsular retensioning could reduce the recurrence rate of instability after surgical stabilization compared with other described techniques. A questionnaire as well as a radiologic workout was obtained from a consecutive series of patients who had undergone this procedure by the same operator between 1986 and 2006. Outcome was determined by the number of redislocations, number of reoperations, the Walch-Duplay score including pain score, and the index of satisfaction. A total of 148 patients responded (42 women and 106 men) with a mean age 28.4±8.7 years (range, 16 to 57 y). The mean follow-up was 14.6 years (range, 2.8 to 22.6 y). Thirty-two patients had hyperlaxity (21%). Three patients (2%) sustained a redislocation or resubluxation. However, none required further operation. Results of the Walch-Duplay score were excellent or good. Fifty-three percent of the patients were pain free, 34% presented occasional pain, 9% moderate pain, and 4% suffered from severe pain. Seventy-nine percent of patients were very satisfied, 18% were satisfied, and 3% were dissatisfied. Mid-term to long-term results of the modification of the Latarjet procedure according to Patte correlate with previous studies with respect to patient satisfaction and functional outcome. The recurrence rate is lower than in previously reported series and may reflect the beneficial effect of systemic capsular retensioning on a flap of coracoacromial ligament. Evidence level IV: Single-surgeon therapeutic case series. © 2013 by Lippincott Williams & Wilkins, Inc.