Retrospective series of 48 shoulders undergoing the Latarjet procedure at MGH (2005-2010). The study reports the incidence and nature of short-term complications: infection, recurrent instability, and neurologic injury. 73% of shoulders had prior surgery, making this a revision-heavy, higher-risk cohort than most published series.
Prior Latarjet outcome series (Allain 7%, Burkhart 5%) did not document neurologic complications at all, giving trainees and patients a falsely reassuring picture of the procedure's risk profile.
When fixing the coracoid graft, use 3.5-mm fully threaded cortical screws. Every recurrent instability case in this series involved cannulated fixation. The mechanism is mechanical: cannulated screws have less thread depth, reducing purchase and graft compression.
Counsel patients preoperatively that neurologic injury occurs in roughly 10% of cases. Musculocutaneous and radial neurapraxias resolve within 2 months, but axillary nerve deficits may be permanent — one patient in this series still had dysesthesias at 5 years.
Flag Workers' Compensation patients as high-risk before scheduling this procedure. A WC claim independently carries a 12-fold increased odds of any complication, consistent with the broader shoulder instability outcomes literature.
Retrospective series of 48 shoulders undergoing the Latarjet procedure at MGH (2005-2010). The study reports the incidence and nature of short-term complications: infection, recurrent instability, and neurologic injury. 73% of shoulders had prior surgery, making this a revision-heavy, higher-risk cohort than most published series.
Prior Latarjet outcome series (Allain 7%, Burkhart 5%) did not document neurologic complications at all, giving trainees and patients a falsely reassuring picture of the procedure's risk profile.
When fixing the coracoid graft, use 3.5-mm fully threaded cortical screws. Every recurrent instability case in this series involved cannulated fixation. The mechanism is mechanical: cannulated screws have less thread depth, reducing purchase and graft compression.
Counsel patients preoperatively that neurologic injury occurs in roughly 10% of cases. Musculocutaneous and radial neurapraxias resolve within 2 months, but axillary nerve deficits may be permanent — one patient in this series still had dysesthesias at 5 years.
Flag Workers' Compensation patients as high-risk before scheduling this procedure. A WC claim independently carries a 12-fold increased odds of any complication, consistent with the broader shoulder instability outcomes literature.