Mid-term Functional Outcomes of Open Congruent Arc Latarjet for Recurrent Anterior Shoulder Instability - A Retrospective Cohort Study

Q: Why is isolated soft-tissue repair often insufficient for recurrent anterior instability with glenoid bone loss?

When glenoid bone loss is significant (particularly >15%), isolated soft-tissue repair has a high risk of failure, leading to recurrent instability.

Sep 29, 2026

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Mid-term functional results are evaluated for open Latarjet with congruent arc modification in recurrent anterior shoulder instability with significant glenoid bone loss. A retrospective cohort study included patients treated between January 2015 and December 2020 with ≥3 anterior dislocations, ≥15% glenoid bone loss, and ≥24 months follow-up. Western Ontario Shoulder Instability Index and Rowe scores improved markedly, with significant gains in flexion and abduction, high graft union on CT, and durable stability estimated by Kaplan–Meier recurrence-free survival.

LanguageEnglish

CategoryHealthcare

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Pages6

Reading Time15 min

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Introduction

Materials and Methods

Results

Conclusion

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Original Article Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 342-347 Mid-term Functional Outcomes of Open Congruent Arc Latarjet for Recurrent Anterior Shoulder Instability: A Retrospective Cohort Study Saurav Narayan Nanda1, Saswat Samant1, Sumit Kaushik1, Ashok Kumar Gachhayat1, Aakash Bhaisora1, Subhrajeet Dash1 Learning Point of the Article: The congruent arc modification enhances glenoid arc restoration and graft contact area, enabling improved stability and predictable outcomes in patients with significant glenoid bone loss undergoing the Latarjet procedure. Abstract Introduction: Recurrent anterior shoulder instability with significant glenoid bone loss is associated with high failure after isolated soft-tissue repair. The open Latarjet procedure with congruent arc modification improves graft coverage and glenoid arc restoration, but mid-term clinical data arelimited. Materials and Methods: This retrospective cohort included patients who underwent open Latarjet with congruent arc modification between January 2015 and December 2020. Eligibility criteria were ≥3 anterior dislocations, ≥15% glenoid bone loss, and ≥24 months of follow-up. Functional outcomes (Western Ontario Shoulder Instability Index [WOSI], Rowe), range of motion, complications, and graft union on computed tomography (CT) were assessed. Kaplan–Meier survival analysis estimated recurrence-free survival. Results: A total of 80 patients (62 males, 18 females; mean age 28.5 ± 6.4years)were analyzed with amean follow-up of 4.5 ± 1.2years. WOSI improved from 46.7 ± 12.3 to 79.4 ± 15.8 (P < 0.001), and Rowe from 32.5 ± 9.6 to 85.6 ± 10.7 (P < 0.001), both exceeding minimal clinically important differencethresholds. Forward flexion (+15°) and abduction (+20°) improved significantly, whereas external rotation showed a mild, non-significant reduction (–10°, P = 0.079). Complications occurred in 12.5%, mainlygraft non-union (5%). CT confirmed graft union in 95%. Kaplan–Meier analysis showed 97.5%recurrence-free survival at 5years. Conclusion: Open Latarjet with congruent arc modification provides clinically meaningful functional improvement, reliable graft union, and durable mid-term stability in recurrent anterior instabilitywith glenoid bone loss. Keywords: Latarjet, congruent arc, shoulder instability, glenoid boneloss, functional outcomes. Introduction Recurrent anterior shoulder instability in young, active patients is frequently associated with glenoid boneloss, particularly when it exceeds 15% of the inferior glenoid diameter. In such cases, isolated soft-tissue repair carries a high risk of failure [1, 2]. The Latarjet procedure addresses this by transferring the coracoid to the glenoid rim, offering both bony augmentation and dynamic stability through the conjoint tendon [3]. The congruent arc modification rotates the coracoid by 90° to increase articular arc coverage and surface contact, potentially enhancing stability and reducing graft-related complications [4, 5, 6 ] . Although biomechanical advantages have been |
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Website: [www.jocr.co.in](www.jocr.co.in)

DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6554](https://doi.org/10.13107/jocr.2025.v15.i12.6554) | Author’s Photo Gallery | | | | | | | --- | --- | --- | --- | --- | --- | --- | | |
Dr. Saurav Narayan Nanda | | | | | | | |
1Department of Orthopedics, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Address of Correspondence:
Dr. Sumit Kaushik,
Department of Orthopaedics Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha 751024, India
E-mail: [iamdrmeet@gmail.com](iamdrmeet@gmail.com) | | | | | | | Submitted: 20/09/2025; Review: 05/10/2025; Accepted: November 2025; Published: December 2025 | | | | | | | | DOI: [https://doi.org/10.13107/jocr.2025.v15.i12.6554](https://doi.org/10.13107/jocr.2025.v15.i12.6554)
© The Author(s). 2025

FAQs

Why is isolated soft-tissue repair often insufficient for recurrent anterior instability with glenoid bone loss?

When glenoid bone loss is significant (particularly >15%), isolated soft-tissue repair has a high risk of failure, leading to recurrent instability.

What patients were included in the retrospective cohort?

Included patients had undergone open Latarjet with congruent arc modification between January 2015 and December 2020, with eligibility criteria of ≥3 anterior dislocations, ≥15% glenoid bone loss, and at least 24 months of follow-up.

Which outcome measures were used to assess functional results and stability?

Functional outcomes were assessed using WOSI and Rowe scores, along with range of motion, complications, and graft union on CT; Kaplan–Meier analysis estimated recurrence-free survival.

Sep 29, 2026

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