2014 Neer Award Paper: Neuromonitoring the Latarjet procedure

Delaney, Ruth A.; Freehill, Michael T.; Janfaza, David; Vlassakov, Kamen; Higgins, Laurence D.; Warner, Jon J.P.

doi:10.1016/j.jse.2014.04.003

Cited by 116 publications

(54 citation statements)

References 15 publications

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“…38 Iatrogenic neurologic injuries are possibly the most concerning, given that clinically detectable transient axillary or musculocutaneous nerve deficits have been reported postoperatively in up to 20.6% of Latarjet procedures with intraoperative nerve monitoring alert episodes occurring in 76.5% of cases. 39 Late coracoid graft resorption after Latarjet procedures is also increasingly recognized. Zhu et al 40 reported that some degree of coracoid graft resorption occurs after greater than 90% of Latarjet procedures; however, the clinical significance of this finding remains unclear because graft resorption did not correlate with functional outcomes or recurrent instability.…”

Section: Discussionmentioning

confidence: 99%

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

McHale

Sánchez

Lavery³

et al. 2017

Arthroscopy Techniques

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Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency. The following Technical Note provides a diagnostic approach for suspected glenohumeral instability, as well as a detailed description of the congruent-arc Latarjet procedure, performed with a deltoid split, with its postoperative management.

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Section: Discussionmentioning

confidence: 99%

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

McHale

Sánchez

Lavery³

et al. 2017

Arthroscopy Techniques

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show abstract

“…The musculocutaneous and radial nerve palsies resolved over a number of months, but the two cases of axillary nerve palsy remained symptomatic and both ultimately underwent neurolysis, with some limited symptomatic relief. Delaney et al further characterized the neurologic complications by performing a neuromonitoring study of the open Latarjet procedure [20,30]. In a study cohort of 40 patients undergoing a Latarjet procedure with an articulated traction device, median somatosensory evoked potentials (SSEPs), transcranial motor evoked potentials (TcMEPs), and free electromyogram (EMG) were measured intraoperatively.…”

Section: Nerve Injurymentioning

confidence: 99%

Complications of the Latarjet procedure

Gupta¹,

Delaney²,

Petkin³

et al. 2015

Curr Rev Musculoskelet Med

167

140

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The Latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss; with good to excellent functional results. Despite excellent clinical results, the complication rates are reported between 15 and 30 %. Intraoperative complications such as graft malpositioning, neurovascular injury, and graft fracture can all be mitigated with meticulous surgical technique and understanding of the local anatomy. Nonunion and screw breakage are intermediate-term complications that occur in less than 5 % of patients. The long-term complications such as graft osteolysis are still an unsolved problem, and future research is required to understand the etiology and best treatment option. Recurrent instability after the Latarjet procedure can be managed with iliac crest bone graft reconstruction of the anterior glenoid. Shoulder arthritis is another complication reported after the Latarjet procedure, which poses additional challenges to both the surgeon and patient.

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“…The soft tissue anatomy around the anterior subscapularis after a coracoid transfer will be scarred and distorted, and the axillary and musculocutaneous nerves are likely to be in an abnormal position 3, 6, 7. Preoperative magnetic resonance images have been used to try and assess the soft tissue anatomy, and a coracoid neo-tendon has been described 8 .…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic All–Intra-articular Revision Eden-Hybinette Procedure for Recurrent Instability After Coracoid Transfer

Tytherleigh-Strong

Mulligan

2019

Arthroscopy Techniques

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Failure, in the form of recurrent shoulder instability, following a coracoid transfer procedure presents a challenging problem. Successful treatment with a revision Eden-Hybinette procedure, by both an open and arthroscopic approach using screws to secure the bone graft, has previously been reported. However, both the open and arthroscopic approach have required careful dissection through the distorted soft-tissue anatomy in the anterior compartment in front of subscapularis to gain access to the front of the glenoid through a muscle split. In this article, we describe a modification of an arthroscopic Eden-Hybinette technique that is undertaken intra-articularly and only requires portals through the rotator interval. This technique avoids having to undertake any extra-articular dissection in the anterior compartment and can address potential problems with retained metalwork and pre-existing anchor voids within the glenoid. In this Technical Note, we describe and highlight the pearls and pitfalls of an all–intra-articular arthroscopic revision Eden-Hybinette procedure.

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2014 Neer Award Paper: Neuromonitoring the Latarjet procedure

Cited by 116 publications

References 15 publications

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

Complications of the Latarjet procedure

Arthroscopic All–Intra-articular Revision Eden-Hybinette Procedure for Recurrent Instability After Coracoid Transfer

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