The Latarjet procedure was first described in 1954. It is a nonanatomic procedure that requires transfer of the coracoid process, together with the conjoint tendon, to the anterior glenoid margin. The aim is to prevent recurrent anterior shoulder dislocation through a "triple blocking" effect, which includes restoring bone loss, providing a dynamic sling effect, and performing capsulolabral repair. Despite the long history of the Latarjet procedure, studies evaluating its impact on scapulothoracic kinematics are sparse. However, there is a concern that scapulothoracic dyskinesia may occur owing to anatomic changes, including release of the coracoacromial ligament and pectoralis minor tendon, a change in the working length and vector of the conjoint tendon, subscapularis split, and capsular closure. The existing literature has major limitations and comprises predominantly small conflicting series that identify either no scapulothoracic dyskinesia after Latarjet or the presence of scapular protraction or retraction. Given that scapular dyskinesia is very common in shoulder instability patients and even asymptomatic general populations, the evidence that the Latarjet procedure results in dyskinesia is not compelling.
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http://dx.doi.org/10.1016/j.arthro.2024.05.017 | DOI Listing |
J 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.
J Exp Orthop
October 2024
Department of Orthopedics Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China.
Purpose: To assess coracoid process morphology in an Asian population using three-dimensional (3D) computed tomography (CT) reconstruction and provide reference values for surgical treatment.
Methods: Data on demographic and shoulder CT characteristics were collected from 142 patients for 3D-CT-based scapular reconstruction. Ten coracoid morphological indicators and the glenoid width were measured.
J ISAKOS
December 2024
Vale Hospital, Madurai. Electronic address:
Background: Treatment decisions for shoulder instability often necessitate surgical intervention, with glenoid bone loss being a key factor. Currently, various techniques exist to identify glenoid bone loss, each with its own advantages and disadvantages. This study introduces the Coraco-Gleno-Scapular (CGS) line as a tool for assessing critical glenoid bone defects.
View Article and Find Full Text PDFJBJS Rev
December 2024
Department of Orthopedic Surgery, University of Iowa Hospital and Clinics, Iowa City, Iowa.
» Suture button fixation has emerged as an effective surgical construct in arthroscopic and open Latarjet and anterior glenoid reconstruction with free autograft bone with high rates of bone block healing.» Biomechanical data suggest that screw and suture button mechanical fixation constructs provide similar load to failure and stability for the Latarjet procedure.» Preliminary bone healing models have identified that flexible fixation may exhibit a higher degree of bone callus maturation, whereas rigid fixation results in excessive callus hyperplasia» Mechanical tensioner use provides consistent tensioning of suture button constructs and improves bone-to-bone healing rates when used for anterior glenoid reconstruction surgery.
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