Anterior shoulder instability can lead to anterior glenoid bone loss associated with humeral posterior deformity (bipolar bone loss). Latarjet procedure is a commonly used surgical option in such cases. However, the procedure is associated with complications in up 15% of the cases often associated with inadequate positioning of coracoid bone graft and screws. Considering that acknowledgment of patient anatomy and use of surgical planning intraoperatively can reduce such complications, we describe the use of 3D printing tools to obtain a 3D Patient-Specific Surgical Guide to aid in the Latarjet procedure. Such tools present advantages and limitations compared to other tools available, which are also discussed in this article.
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http://dx.doi.org/10.1016/j.eats.2023.02.027 | DOI Listing |
Am J Sports Med
January 2025
Mayo Clinic Arizona Department of Orthopedic Surgery, Phoenix, Arizona, USA.
Background: The Latarjet and other bony augmentation procedures are commonly used to treat anterior shoulder instability in the setting of significant glenoid bone loss. Although several fixation strategies have been reported, the biomechanical strength of these techniques remains poorly understood.
Purpose: To perform a systematic review of the biomechanical strength of glenoid bony augmentation procedures for anterior shoulder instability.
The Latarjet procedure is a successful treatment for anterior shoulder instability with less than 5% having redislocations - revision surgery and prior surgery having been shown to be significant risk factors for recurrence. Approximately 90% of athletes return to play after Latarjet, comparable to arthroscopic Bankart repair. Patients may be physically unable to return to play, which may be due to persistent pain, apprehension, or weakness.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA.
Background: The Latarjet procedure is considered the gold standard for treating patients with anterior shoulder instability in the presence of critical glenoid bone loss. Proponents of the Latarjet contend that its efficacy is in-part attributable to the "sling effect" of the conjoint tendon; however, recent studies have demonstrated similar restoration of anterior stability in patients undergoing free bone block (FBB) procedures. The purpose of this systematic review was to evaluate the biomechanical and clinical evidence for the sling effect.
View Article and Find Full Text PDFJ Orthop Res
December 2024
AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.
Anterior shoulder instability with glenoid bone lesion can be treated with the Eden-Hybinette procedure utilizing a tricortical iliac crest bone graft or the Latarjet procedure. This study aimed to evaluate the glenohumeral joint (GHJ) kinematics throughout an external shoulder rotation following the Eden-Hybinette and Latarjet procedures. Nine human specimens were examined with dynamic radiostereometry during a GHJ external rotation with anteriorly directed loads from 0 to 30 N.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Concordia Hospital, Rome, Italy.
Background: To analyze how patient history, glenoid bone loss (GBL), and the size of the residual glenoid bone fragment (GBF) influence the choice between arthroscopic Bankart repair and open Latarjet procedure in patients with anteroinferior glenohumeral instability and bony Bankart lesions.
Methods: Review of 290 patients with bony Bankart lesions treated for anterior glenohumeral instability was conducted and patients were categorized into three groups based on GBL and GBF: Group A (GBL < 10% and GBF <10%), Group B (GBL ≥ 10% and GBF <10%), and Group C (GBL ≥10%, GBF ≥10%). Number of preoperative dislocations, time from the first instability, Western Ontario Shoulder Index (WOSI) scores, Hill-Sachs lesion (HSL) location (central or peripheral), HSL track status, and Glenoid Track Instability Management Score (GTIMS) were analyzed.
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