Arthroscopic Latarjet procedure with double button fixation: Learning curve analysis and short-term complications

Bonnevialle, Nicolas; Vogel, Jérôme; Thélu, Charles-Édouard; Azoulay, Vadim; Bouju, Yves

doi:10.1016/j.rcot.2017.09.297

Cited by 5 publications

(30 citation statements)

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“…Six out of the eight studies of this review (75%) had a level of evidence IV [14][15][16][17]20,21 and two studies (25%) were of level III. 18,19 The mean modified Coleman score for methodological deficiencies of the studies was 62.5/100, whereas it ranged from 55/100 21 to 70/100 (Table 1).…”

Section: Resultsmentioning

confidence: 93%

“…15 In total, 750 patients were included in this review (424 patients treated with non-rigid fixation and 326 patients who underwent rigid fixation). The gender was reported in seven out of eight studies [14][15][16][17][18]20,21 and most (85%) of the patients were males. The mean age of the patients per study varied between 25 15 and 30 years, 15,21 while the mean follow-up ranged from 1 18 to 18 years.…”

Section: Resultsmentioning

confidence: 98%

“…Eight out of the 325 initial studies were finally chosen according to our inclusion-exclusion criteria. [14][15][16][17][18][19][20][21] A summary flowchart of our literature search according to PRISMA guidelines can be found in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…[15][16][17]19 Amongst all, only two studies were controlled, 18,19 whereas the rest were case series. [14][15][16][17]20,21 Specifically, Gendre et al 18 compared patients who underwent Bristow (standing position of the graft) and Latarjet procedures (lying position of the graft), while Metais et al 19 compared patients who underwent modified Latarjet-Patte procedure performed by open surgery, arthroscopic surgery with screw fixation, or arthroscopic surgery with endobutton fixation. All studies in this review [14][15][16][17][18][19][20][21] were published between 2014 and 2018 (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Non-rigid fixation of the glenoid bone block for patients with recurrent anterior instability and major glenoid bone loss: A systematic review

et al. 2019

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Background New types of glenoid bone block fixation, involving suture buttons, suture anchors or even implant-free impaction of the graft, have been recently introduced. In contrast to screws which allow for a rigid fixation of the bone block, these alternative procedures provide a non-rigid type of fixation. Methods Two reviewers independently conducted the search in a systematic way (according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “Latarjet” OR “Eden-Hybbinette” OR “bone block” AND “anterior” AND “shoulder” AND “instability.” Results Eight out of the 325 initial studies were finally chosen according to our inclusion–exclusion criteria. In total, 750 patients were included in this review. The overall anterior instability recurrence rate for patients treated with non-rigid fixation was 2.6%, while the overall rate of non-union or graft osteolysis was 5.4%. Conclusions Regardless of the graft type, bone block non-rigid fixation showed satisfactory clinical and functional outcomes for the treatment of anterior shoulder instability with substantial glenoid bone deficiency. Furthermore, non-rigid fixation resulted in adequate bone graft healing and osseous incorporation. Lastly, given the relative lack of data, further prospective controlled studies are required to assess bone block non-rigid fixation procedures in comparison with the traditional rigid (with screws) fixation techniques. Level Systematic review, IV.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Non-rigid fixation of the glenoid bone block for patients with recurrent anterior instability and major glenoid bone loss: A systematic review

et al. 2019

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“…Therefore, some studies have advocated the use of suture-button fixation during the Latarjet procedure to reduce the aforementioned complications. 4,10,25 This modification is considered to improve the accuracy of bone location and avoid complications, with no reported neurological or implant complications at a mean follow-up period of 14 months. Meanwhile, a biomechanical study showed that the screw and suture-button fixation techniques exhibit comparable biomechanical strength for coracoid bone block fixation during the Latarjet procedure.…”

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confidence: 99%

Modified Arthroscopic Latarjet Procedure: Suture-Button Fixation Achieves Excellent Remodeling at 3-Year Follow-up

Liu

Lü

et al. 2019

Am J Sports Med

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Background: Some studies have advocated the use of suture-button fixation during the Latarjet procedure to reduce complications associated with screw fixation. However, the sample size of these studies is relatively small, and their follow-up period is short. Purpose: To investigate the efficacy of the suture-button Latarjet procedure with at least 3 years of follow-up and remodeling of the coracoid graft. Study Design: Case series; Level of evidence, 4. Methods: A total of 152 patients who underwent the suture-button Latarjet procedure between February 2013 and February 2016 were selected, and 128 patients who met the inclusion criteria were enrolled in this study. Preoperative and postoperative clinical results were assessed. The position and healing condition of the coracoid graft and arthropathy of the glenoid and humeral head were also assessed using radiography and 3-dimensional computed tomography (CT). Results: The mean follow-up time was 40.3 ± 5.8 months. There were 102 patients included in this study. The mean visual analog scale score for pain during motion, the American Shoulder and Elbow Surgeons score, the Rowe score, and the Walch-Duplay score were improved considerably. A total of 100 grafts achieved bone union. The overall absorption rate was 12.6% ± 4.3%. Graft absorption mostly occurred on the edge and outside the “best-fit” circle of the glenoid. A vertical position was achieved in 98 grafts (96% of all cases) immediately postoperatively, with the mean graft midline center at the 4 o’clock position. In the axial view, CT showed that 89 grafts were flush to the glenoid, whereas 2 and 11 grafts were fixed medially and laterally, respectively. In all cases, the bone graft and glenoid tended to extend toward each other to form concentric circles during the remodeling process. During follow-up observations, the height of the 11 grafts that were positioned laterally (ie, above the glenoid level) exhibited a wave-curved change. No arthropathy was observed in any patient. Conclusion: Patient outcomes were satisfactory after the modified arthroscopic suture-button Latarjet technique. Graft absorption mostly occurred on the edge and outside the “best-fit” circle of the glenoid. The graft exhibited the phenomenon of ectatic growing when it fused with the glenoid and finally remodeled to a new concentric circle with the humeral head analogous to the original glenoid. Grafts positioned laterally did not cause arthropathy of the joints within the period of the study.

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Screw Removal Can Resolve Unexplained Anterior Pain Without Recurrence of Shoulder Instability After Open Latarjet Procedures

et al. 2020

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Background: Anterior shoulder instability can be successfully treated using Latarjet procedures, although a small proportion of patients report unexplained pain. Purpose/Hypothesis: The purpose was to report the prevalence and characteristics of patients with unexplained pain without recurrent instability after open Latarjet procedures and to determine whether screw removal can alleviate pain. The hypothesis was that unexplained pain without recurrent instability might be due to soft tissue impingements against the screw heads and that the removal of screws would alleviate or reduce pain. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively reviewed the clinical and radiographic records of 461 consecutive shoulders treated by open Latarjet procedures for anterior instability between 2002 and 2014. Unexplained anterior pain was present in 21 shoulders (4.6%) and treated by screw removal at 29 ± 37 months (mean ± SD). Postoperative assessment at >12 months after screw removal included complications, visual analog scale for pain (pVAS), subjective shoulder value, Rowe score, Walch-Duplay score, and ranges of motion. The study cohort comprised the shoulders of 20 patients (9 women, 11 men) aged 25 ± 6 years (median, 25 years; range, 16-34 years) at screw removal and involved the dominant arm in 13 (62%) shoulders. Results: Screw removal alleviated pain completely in 14 shoulders (67%; pVAS improvement, 6.4 ± 1.8; median, 6; range, 3-8) and reduced pain in the remaining 7 (33%; pVAS improvement, 2.4 ± 1.4; median, 2; range, 1-5). At 38 ± 23 months after screw removal, 2 recurrences of instability unrelated to screw removal occurred. The subjective shoulder value was 79% ± 22% (median, 90%; range, 0%-95%); Rowe score, 85 ± 20 (median, 95; range, 30-100); and Walch-Duplay score, 82 ± 19 (median, 85; range, 25-100). Mobility improved in active forward elevation (171°± 14°), external rotation with the elbow at the side (61°± 12°), and external rotation with the arm at 90° of abduction (67°± 13°) and especially in internal rotation, with only 2 shoulders (10%) limited to T12 spine segment. Conclusion: The present findings confirm that unexplained anterior pain after Latarjet procedures can be related to the screws used to fix bone blocks, which can safely be alleviated or reduced by screw removal.

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Arthroscopic Latarjet procedure with double button fixation: Learning curve analysis and short-term complications

Cited by 5 publications

References 0 publications

Non-rigid fixation of the glenoid bone block for patients with recurrent anterior instability and major glenoid bone loss: A systematic review

Non-rigid fixation of the glenoid bone block for patients with recurrent anterior instability and major glenoid bone loss: A systematic review

Modified Arthroscopic Latarjet Procedure: Suture-Button Fixation Achieves Excellent Remodeling at 3-Year Follow-up

Screw Removal Can Resolve Unexplained Anterior Pain Without Recurrence of Shoulder Instability After Open Latarjet Procedures

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