Arthroscopic Bristow-Latarjet Procedure

The understanding and operative options available for the arthroscopic treatment of anterior shoulder instability have increased considerably. However, despite these advances, a significant failure rate remains when surgical procedures do not adequately address the underlying pathology. The open Bristow-Latarjet technique has become an increasingly popular procedure that is able to address both bone loss and soft tissue deficiency with excellent and reliable results. With the open technique, precise placement of the coracoid bone graft can be difficult because of limited exposure, and problems with inaccurate bone graft positioning do occur. Neurologic injury in the form of traction neuropraxias to the musculocutaneous and axillary nerves has also been reported. Techniques to undertake the Bristow-Latarjet procedure arthroscopically have been developed, in part, to potentially address some of these problems. This article describes the step-by-step operative technique for an arthroscopic Bristow-Latarjet procedure and has been illustrated with intraoperative images and video clips.