Pectoralis minor reattachment in Latarjet procedure: improvement of scapular stability in high-performance contact athletes- retrospective cohort comparison

The Latarjet procedure is effective for recurrent anterior shoulder instability with glenoid bone loss; however, as a nonanatomic technique, it may lead to scapular dyskinesis, particularly in contact athletes. The necessity of reattaching the pectoralis minor remains a subject of debate. We hypothesized that pectoralis minor reattachment during the Latarjet procedure would be associated with a lower incidence of scapular dyskinesis and improved functional outcomes in high-performance contact athletes. A retrospective, assessor-blinded, case-control study was conducted on 38 high-performance contact athletes with recurrent anterior shoulder instability and glenoid bone loss who underwent the Latarjet procedure between January 2020 and December 2023. Patients were divided into 2 equal groups (n = 19): an intervention group (with pectoralis minor reattachment) and a control group (without reattachment). With a minimum follow-up of 24 months, outcomes were evaluated using range of motion, the University of California at Los Angeles shoulder rating scale, and 5 scapular dyskinesis tests: scapular dyskinesis test, lateral scapular slide test at 30&#xb0; and 90&#xb0;, scapular reposition test, and scapular assistance test. The Benjamini-Hochberg correction was applied to account for multiple comparisons. Logistic regression analysis demonstrated that pectoralis minor reattachment was associated with a significant reduction in positive dyskinesis tests across all 5 assessment tools, with odds ratios ranging from 0.007 to 0.095 (all adjusted P &#x2264; .002 after correction). External rotation at 90 degrees of abduction was significantly higher in the intervention group (105&#xb0; vs. 86&#xb0;, P < .001), exceeding the minimal clinically important difference of 10&#xb0;. University of California at Los Angeles scores were higher in the intervention group (34 vs. 29 points, P < .001), exceeding the minimal clinically important difference of 3 points. Pectoralis minor reattachment during the Latarjet procedure is associated with a lower prevalence of scapular dyskinesis and improved functional outcomes in high-performance contact athletes. A prospective randomized trial is warranted to determine if these associations are causally related to pectoralis minor repair.