The Value of Arthroscopy Before an Open Modified Latarjet Reconstruction

Purpose: The purpose of this study was to identify the presence of intra-articular pathology in patients undergoing shoulder arthroscopy immediately before modified Latarjet reconstruction for recurrent anterior instability with bone deficiency. Methods: The records of 33 consecutive patients who underwent shoulder arthroscopy immediately before the modified Latarjet reconstruction were analyzed. Arthroscopy was performed just before the open procedure to identify and treat intra-articular pathology that would otherwise have been missed or not well treated during the routine open anterior approach to the shoulder. Results: In 24 of 33 cases (73%) associated pathologic lesions were identified and addressed arthroscopically (lesions not likely to have been discovered and treated optimally during the open deltopectoral approach). We identified and addressed 21 type 2 SLAP lesions (64%) as well as 1 posterior Bankart lesion, 2 loose bodies, 2 rotator cuff tears, and 2 localized areas of grade 4 chondromalacia. Conclusions: Arthroscopic examination before modified Latarjet reconstruction is recommended because it allows the surgeon to identify and arthroscopically address associated pathologic entities that are present in over two thirds of the cases. Level of Evidence: Level IV, therapeutic case series.