Open Latarjet Procedure for Anterior Shoulder Instability: A Correlation Between Preoperative Imagistic Landmarks and 6-Month Follow-Up

Background: The open Latarjet procedure is widely used for the treatment of recurrent anterior shoulder instability associated with bipolar bone defects. Preoperative imaging parameters may be associated with short-term functional outcomes following the open Latarjet procedure for recurrent anterior shoulder instability. Materials and Methods: This retrospective study included 16 patients treated with the modified open Latarjet procedure. Preoperative CT or MRI measurements included glenoid bone loss, Hill–Sachs interval (HSI), glenoid track (GT), HSI/GT ratio and glenoid index. At 6 months, patients were evaluated using the auto-Rowe and auto-Walch–Duplay scores, range of motion, recovery time, residual symptoms, and return to activity. Results: The median Rowe and Walch–Duplay scores were 95 (90–95) and 75 (70–90), respectively. Fifteen patients resumed physical activity, including seven who returned to their previous level. No procedure-related complications were reported. Among the imaging parameters analysed, a higher HSI/GT ratio was associated with lower Walch–Duplay (p = 0.007, q = 0.043) and Rowe scores (p = 0.014, q = 0.043). Higher glenoid bone loss was associated with a lower Rowe score (p = 0.015, q = 0.043), while a higher glenoid index was associated with a lower Walch–Duplay score (p = 0.017, q = 0.043). Glenoid track showed a positive nominal association with the Walch–Duplay score (p = 0.036), which did not remain significant after FDR adjustment (q = 0.072). Discussion: Preoperative assessment of bipolar bone loss, particularly the HSI/GT ratio, may provide complementary information for surgical planning and for exploring associations with short-term functional outcomes. The formula proposed by Boden may help determine whether the coracoid graft is sufficient to convert an off-track lesion into an on-track lesion. In patients with larger Hill–Sachs defects, additional remplissage or humeral head bone grafting may be considered, although these techniques carry risks of external rotation restriction and graft resorption or osteonecrosis, respectively. Conclusions: The open Latarjet procedure is a widely used surgical option for anterior shoulder instability. These exploratory findings require validation in larger cohorts with longer follow-up.