A Biomechanical Comparison of Two Techniques of Latarjet Procedure in Cadaveric Shoulders

Abstract

Traumatic anterior instability of the shoulder is commonly treated with the Latarjet procedure, which involves transfer of the coracoid process with a conjoint tendon to the anterior aspect of the glenoid. The two most common techniques of the Latarjet are the classical and congruent arc techniques. The aim of this study was to evaluate the difference in force required to dislocate the shoulder after classical and congruent arc Latarjet procedures were performed. Fourteen cadaveric shoulders were dissected and osteotomised to produce a bony Bankart lesion of 25% of the articular surface leading to an “inverted pear-shaped” glenoid. An anteroinferior force was applied whilst the arm was in abduction and external rotation using a pulley system. The force needed to dislocate was noted, and then the shoulders underwent coracoid transfer with the classical and congruent arc techniques. The average force required to dislocate the shoulder after osteotomy was 123.57 N. After classical Latarjet, the average force required was 325.71 N, compared with 327.14 N after the congruent arc technique. This was not statistically significant. In this biomechanical cadaveric study, there is no difference in the force required to dislocate a shoulder after classical and congruent arc techniques of Latarjet, suggesting that both methods are equally effective at preventing anterior dislocation in the position of abduction and external rotation.

Latarjet procedure for failed arthroscopic Bankart repair: a case report

“…However several recent study have shown of reccurent rates up to 9%-40%. 1,2 Many factors including young age at the time of surgery, male sex, bony defects, joint hyperaxity, contact sport, poor quality capsules, forced overhead activity, and bony structures of glenoid and humeral head. [3][4][5] The surgical treatment of anterior instability is evolving and more than 150 operation have been described for the treatment of reccurent anterior dislocation of the shoulder.…”

“…The aim of surgery is to repair the capsule-labral soft tissue structures, and if required, the osseous defects, in order to provide anterior restraint and decrease the capsular volume. 1 The Latarjet procedure, first described by Michel Latarjet in 1954, is used for recurrent anterior instability of the glenohumeral joint, most commonly associated with glenoid bone loss, or following failed soft tissue stabilisation procedures. The Latarjet procedure involves passing an osteotomised coracoid process graft with attached conjoint tendon through a horizontal splitting of the subscapularis tendon and securing the graft onto the anterior surface of the glenoid where the bony defect has occurred.…”

Traditional versus congruent-arc Latarjet anatomic and biomechanical perspective

“…However, a recent study found no significant differences regarding the stability provided by both techniques. 23 The authors produced a 25% bony lesion in 14 cadaveric shoulders and compared the difference in force required to dislocate the shoulder after reconstruction with the TL and CAL procedures. An anteroinferior force was applied whilst the arm was in abduction and external rotation using a pulley system.…”

“…The authors reported that the average force required to dislocate the shoulder after the classic Latarjet was 325.71 N, compared with 327.14 N after the congruent-arc technique, and this difference was not statistically significant. 23 …”

Editorial Commentary: Classic and Congruent-Arc Latarjet Techniques Are Equally Safe and Effective Procedures, so Choose Whichever Technique Works Best in Your Hands for Your Patients

“…In 1 cadaveric study using a 25% glenoid bony defect, both the classic and congruent-arc techniques showed nearly identical force to dislocation after reconstruction. 13 In a cadaveric model of 30% glenoid bone loss, another study showed…”