The present study aimed to investigate patients’ perceptions and preferences regarding arthroscopic or open approaches for the Latarjet procedure. The factors influencing patients’ decisions and the predictability of their approach were investigated. The hypothesis was that patients would prefer the arthroscopic option due to its less invasive appearance.

Between May 2022 and March 2023, all patients who had a primary, whether arthroscopic or open glenohumeral stabilization according to Latarjet performed by senior authors, were considered potentially eligible for inclusion in this prospective study. Patients were contacted by an independent examiner (B.C.) before surgery to realize a structured interview designed in a stepwise fashion. The stepwise model, based on published literature, was designed with consideration of the sequence in which consent-taking is usually performed, in essence: (1) indications for the procedure; (2) details about the procedure; (3) risks and benefits; (4) communication of choice or consent; and (5) invitation for further questions.

Fifty patients with a mean age of 28.8±8.8 years old participated in the study. Twenty (40%) consistently selected an arthroscopic approach after analysis of the incision's aspect, whereas 34 (68%) had a final decision different from their initial choice. In addition, out of the 15 patients who chose arthroscopy or were undetermined after presentation of the incisional aspect, 9 (60%) changed their decision to open surgery after presentation of the pros and cons of each approach. Twenty-three (46%) patients were unable to choose and left the choice to their surgeon. The faith in their surgeon and recovery were identified as the two most important factors influencing patients’ final decisions.

Arthroscopic incisions are not cosmetically more attractive to patients than the single incision of an open approach. The advantages of the arthroscopic procedure may not be as valued by patients as by surgeons. Besides the cosmetic aspect, the patients were more interested in the equivalent short- and mid-term outcomes of both approaches and the shorter surgical duration of the open option. It is crucial to adequately inform patients during preoperative counseling to achieve the best consensus.