Arthroscopically-assisted Latarjet: an easy and reproducible technique for improving the accuracy of graft and screw placement

Taverna, Ettore; Guarrella, Vincenzo; Cartolari, R.; Ufenast, Henri; Broffoni, Laura; Baréa, Christophe; Garavaglia, Guido

doi:10.1177/1758573217706701

Cited by 9 publications

(11 citation statements)

References 21 publications

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“…The mini-open approach to harvest, prepare and handle the coracoid with the conjoint tendon is more comfortable, quicker and safer than the arthroscopic procedure avoiding dangerous portals medial to the coracoid. The round-endobutton fixation and the glenoid guide provides better bony integration of the coracoid than the use of the screws through an anterior approach [27]. Cowling et al [42] reported an overall mean rate of screws loosening of 1.45% (0 to 4.26%) using two screws for fixation and a mean rate of 2.08% (0 to 6.45%) of loosening using one screw; the mean rate of nonunion was comparable in both groups and revision procedures were 5.16% (0 to 35.7%) using two screws, and in 1.25% using one screw (0.84 to 11.5%) [42].…”

Section: Discussionmentioning

confidence: 99%

“…The use of the aiming device, with creation of two bony tunnels, permit the realization of two perfectly parallel tunnels with 5mm offset from the glenoid rim [27,44]. The bony tunnels should be directed parallel to the glena and perpendicular to the graft and glenoid neck.…”

Section: Discussionmentioning

confidence: 99%

“…The bony tunnels should be directed parallel to the glena and perpendicular to the graft and glenoid neck. This technique of tunnel's placement, together with the preparation of the glenoid neck with a flat freshened cancellous bone and the use of a tensioner support give for the fixation, permits to obtain an excellent balanced tension among the two double pairs of round endobuttons [27,40,[44][45][46].…”

Section: Discussionmentioning

confidence: 99%

“…The drill guide (Smith & Nephew Inc., USA) is used to ensure that the two drill tunnels are perpendicular to the neck of the glenoid and parallel to each other [27]. It is inserted from a posterior accessory portal and centred on the glenoid defect below the mid-line (Fig.…”

Section: Surgical Techniquementioning

confidence: 99%

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A new mini-open technique of arthroscopically assisted Latarjet

Taverna

Longo

Guarrella

et al. 2020

BMC Musculoskelet Disord

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Background: The aim is to describe a new arthroscopically assisted Latarjet technique. Methods: We evaluated the clinical and radiological findings of 60 patients with chronic recurrent anterior gleno-humeral instability who underwent, between September 2013 and November 2014, an arthroscopically-assisted Latarjet procedure with double round endobutton fixation. Inclusion criteria were: chronic anterior recurrent instability, Instability Severity Index Score (ISIS) greater than three points, a glenoid bone defect > 15% or a Hill Sachs lesion with concomitant glenoid bone defect > 10%. During surgery the joint capsule and the anterior glenoid labrum were detached. Two drill tunnels perpendicular to the neck of the glenoid were made through a guide. An accessible pilot hole through the glenoid was created to allows the passage of guidewires for coracoid guidance and final fixation onto the anterior glenoid. Through a restricted deltopectoral access a coracoid osteotomy was made. Finally, the graft was prepared, inserted and secured using half-stitches. Results: The mean follow-up was 32.5 months (range 24-32 months). At a mean follow-up, 56 of the 60 subjects claimed a stable shoulder without postoperative complaints, two (3.3%) had an anterior dislocation after new traumatic injury, and two (3.3%) complained of subjective instability. At the latest follow-up, four subjects complained of painful recurrent anterior instability during abduction-external rotation with apprehension. At 1 year, the graft had migrated in one patient (1.7%) and judged not healed and high positioned in another patient (1.7%). Moreover, a glenoid bony gain of 26.3% was recorded. At the latest follow-up, three patients had grade 1 according to Samilson and Prieto classification asymptomatic degenerative changes. Nerve injuries and infections were not detected. None of the 60 patients underwent revision surgery. Healing rate of the graft was 96.7%. Conclusions: This technique of arthroscopically assisted Latarjet combines mini-open and arthroscopic approach for improving the precision of the bony tunnels in the glenoid and coracoid placement, minimizing any potential risk of neurologic complications. It can be an option in subjects with anterior gleno-humeral instability and glenoid bone defect. Further studies should be performed to confirm our preliminary results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

See 2 more Smart Citations

A new mini-open technique of arthroscopically assisted Latarjet

Taverna

Longo

Guarrella

et al. 2020

BMC Musculoskelet Disord

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“…Andover, MA) was inserted posteriorly and its arm was placed flush along the face of the glenoid with the hook passing over the edge ( Fig 3 A). 6 The hook was centered on the glenoid defect with the tip of the hook over the glenoid rim, usually at the 4-o'clock position (right shoulder). Once the guide was positioned, a bullet was placed in the inferior hole of the guide.…”

Section: Surgical Technique (With Video Illustration)mentioning

confidence: 99%

Arthroscopic Latarjet Procedure: A Technique Using Double Round ENDOBUTTONs and Specific Glenoid and Coracoid Guides

Castricini

Taverna

Guarrella

et al. 2020

Arthroscopy Techniques

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The Latarjet procedure is a method used for the treatment of shoulder instability in the presence of bone loss. A decade after the first description of the fully arthroscopic Latarjet procedure, modifications to the technique were reported to decrease the risk of complications and improve the position of the bone block. A recent trend toward the use of buttons to fix the coracoid has been reported. The technique described here is an arthroscopic Latarjet procedure that uses 2 pairs of round buttons as an alternative to screw fixation or the use of a single button, and the technique aims to combine the original procedure with safe and stable fixation.

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