目的：探讨改良关节镜下喙突移位Latarjet手术的技术特点及手术效果。方法：关节镜下Latarjet手术是治疗复杂肩关节前方不稳定的有效方法，而经典的关节镜下Latarjet手术没有进行前方关节囊的重建，且术中对肩胛下肌破坏较明显。从2013年2月开始，北京积水潭医院运动损伤科对经典关节镜下Latarjet手术进行改良，术中加入前方关节囊重建术，并采取经腱腹结合部位分离肩胛下肌的技术充分保护肩胛下肌，术后第2天行CT检查评价骨移植物位置。结果：2013年2月至2014年8月，共有51例肩关节前向不稳定患者行改良后的关节镜下Latarjet手术，所有患者手术均顺利完成，术后CT显示，骨块与肩盂平齐的病例为48例（94.1%），偏内侧病例3例（5.9%）。骨块位于2点至5点位置的病例49例占96.0%，高于2点位置1例占2.0%，低于5点位置1例占2.0%。术后随访未发现复发脱位及半脱位。结论：改良关节镜下Latarjet手术不仅可按照经典切开术式进行操作，同时又能兼具关节镜下手术的微创、精细等优势，喙突骨块可达到良好的位置，手术结果满意。

Objective: To present the surgical technique and to evaluate the results of the modified arthroscopic Latarjet procedure. Methods: Arthroscopic Latarjet procedure has proven to be a reliable method of treatment for difficult anteroinferior instability of the shoulder joint. However, there is no anterior capsule reattachment and too much subscapularis damage for the classic procedure. From February 2013, we modified the classic procedure with reattachment of anterior joint capsule and muscle-tendon junction splitting of subscapularis. Coracoid graft position was evaluated using CT scanning. Results: From March 2012 to August 2014, 51 modified Latarjet procedures were successfully performed arthroscopically for patients with anterior shoulder instability. According to the CT scanning at the final follow up, the graft was flush with the glenoid in 94.1%, and medially placed in 5.9%. Vertical positioning was perfect in 96.0% (2 to 5 o’clock), too high in 2.0%, and too low in 2.0%. There were no cases of recurrent dislocation or subluxation. Conclusion: The modified arthroscopic Latarjet procedure has shown satisfactory results with good graft positioning. It is a minimal invasive and accurate approach, which combines the advantages of the open procedure.