The Trillat procedure: a systematic review of complications and outcome

Background: The Trillat procedure is a surgical treatment for recurrent anterior shoulder instability. It consists of an inferior closed-wedge osteoclasy of the coracoid process. Nowadays, it is used to treat selected cases of shoulder instability. This systematic review aims to provide an overview of clinical and functional outcomes, recurrence rate, and complications of the Trillat procedure for recurrent anterior shoulder instability.

Methods: A systematic review of the literature regarding the Trillat procedure for recurrent anterior shoulder instability was carried out on Medline, through PubMed, and Embase. The English and French literature published before the 4^th of November 2023 was analyzed. The data regarding demographics, outcome, recurrency, and complications were reported.

Results: From 38 articles with the primary search, seven manuscripts were enrolled. A total of 419 patients and 443 shoulders were analyzed, with a mean age of 35.46 (range 25-61) years. The mean follow-up was 65.01 (range 24.8-132) months postoperative. The pooled data showed 91.2% of subjective satisfaction, weighted mean postoperative Rowe score of 86.25 points, Walch-Duplay of 84.6 points, and a Constant-Murley Score of 84.82 points. The recurrence rate was 10.28% for all the articles involved and 8.51% for the articles proposing the procedure for selected case of anterior instability, with low-grade glenoid bone loss. The most common complications were a loss of external rotation and the development of osteoarthritis.

Conclusion: The Trillat procedure for recurrent anterior shoulder instability showed promising results, especially in selected cases, such as low-grade glenoid bone loss, with massive irreparable cuff tears or hyperlaxity.