Shoulder Instability Surgery: Latarjet Technique With Surgical Tape Versus Screw Fixation

The primary outcome of this study is shoulder-specific functional outcome at 12 months following surgery, measured using the Western Ontario Shoulder Instability Index (WOSI).

The WOSI is a validated, disease-specific patient-reported outcome measure designed to assess quality of life and functional impairment in patients with shoulder instability. It consists of 21 items grouped into four domains: physical symptoms, sport/recreation/work function, lifestyle function, and emotional well-being. Each item is scored on a visual analog scale, and the total score ranges from 0 to 2100 points, where lower scores indicate better shoulder function and fewer symptoms.

The primary analysis will compare the total WOSI score at 12 months postoperatively between the two study groups: high-strength suture tape cerclage fixation and metal screw fixation of the coracoid graft in the Latarjet procedure.

A secondary outcome of this study is shoulder stability and functional outcome at 12 months following surgery, assessed using the ROWE Score.

The ROWE Score is a validated clinical scoring system specifically developed to evaluate outcomes in patients with shoulder instability. It assesses three main components: stability (50 points), motion (20 points), and function (30 points), with a total possible score of 100 points. Higher scores indicate better shoulder stability and function.

The total ROWE Score at 12 months postoperatively will be compared between the two study groups: high-strength suture tape cerclage fixation and metal screw fixation of the coracoid graft during the Latarjet procedure.

A secondary outcome of this study is postoperative shoulder pain at 12 months, assessed using the Visual Analog Scale (VAS).

The VAS is a validated and widely used patient-reported measure of pain intensity. It consists of a 10-centimeter horizontal line anchored by two extremes: "no pain" (0) and "worst imaginable pain" (10). Patients are asked to indicate the point on the line that best represents their current level of shoulder pain. The score is recorded as a numerical value from 0 to 10, with higher scores indicating greater pain intensity.

Pain levels at 12 months following surgery will be compared between the two study groups: high-strength suture tape cerclage fixation and metal screw fixation of the coracoid graft in the Latarjet procedure.

A secondary outcome of this study is return to sport following surgery, evaluated at 12 months postoperatively.

Return to sport will be defined as the patient's ability to resume participation in sports activities at the same or lower level compared to pre-injury status. Information will be collected regarding whether the patient has returned to sport (yes/no), the level of performance achieved (same level, lower level, or unable to return), and the time elapsed from surgery to return to sport (measured in months).

A secondary outcome of this study is radiological consolidation of the coracoid graft at 12 months following surgery.

Graft union will be assessed using computed tomography (CT) scans performed at 3 and 12 months postoperatively. Radiological consolidation will be defined as the presence of continuous trabecular bone bridging between the coracoid graft and the native glenoid bone, without radiolucent lines suggestive of non-union

A secondary outcome of this study is the incidence of postoperative complications within 12 months following surgery.

Complications will include both early and late adverse events related to the surgical procedure or the fixation method. Specifically, the following events will be recorded: coracoid graft fracture, significant graft resorption, graft malposition, fixation device malposition or failure, non-union, recurrent instability, infection, neurovascular injury, and need for reoperation (including hardware removal or revision surgery).