Bristow-Latarjet procedure with specific instrumentation: study of 34 cases

Abstract

A Bristow-Latarjet procedure with specific instrumentation was performed for recurrent dislocation or subluxation of the glenohumeral joint in 34 patients. The procedure was performed through a subscapularis splitting approach with three specific instruments and a special screw. The clinical outcome was assessed by the Duplay and the Constant scores. Radiographic study was conducted on 23 patients and CT scan in 11 patients. Of the 27 patients interviewed 92% were satisfied. Of the 23 patients examined, 15 had an excellent Duplay score, four a good score, three a medium score, and only one had a bad score. One patient had subluxation episodes, and one patient was revised after a redislocation following violent trauma. On the standard radiographs, all bone blocks were in the correct position. A pseudarthrosis was diagnosed in the patient with subluxation episodes. This device simplifies the surgical technique and provides reproducibility to the procedure.Résumé Le procédé de Bristow-Latarjet avec une instrumentation spécifique a été utilisé dans les luxations ou les sub-luxations récidivantes de l'épaule sur 34 patients en utilisant un abord suscaplulaire à l'aide d'instruments spécifiques et d'une vis spéciale. Le suivi clinique a été évalué selon le score de Duplay et de Constant. L'évalua-tion radiologique réalisée sur 23 patients avec un scanner chez 11 patients. Sur les 27 patients interrogés, 92% étaient satisfaits. Sur les 23 patients examinés 15 avaient un excellent score de Duplay, 4 un bon score, 3 un score moyen et un seul un mauvais score. Un patient présentait des épisodes de subluxations résiduelles et un patient a été réopéré après une récidive de la luxation secondaire à un violent traumatisme. Sur les radiographies standard, toutes les butées osseuses sont en position correcte. Une pseudarthrose a été diagnostiquée chez le patient présentant des épisodes de subluxations. Ce matériel simplifie la technique chirurgicale et permet d'avoir une technique reproductible.

Complications associated with open coracoid transfer procedures for shoulder instability

“…Study details including patient demographics, follow-up characteristics and details of previous surgery are presented in Table I. These 30 studies described the results of 1658 open coracoid transfer procedures for shoulder instability. Three percent of cases (20 of 636) from 14 studies 1,5,6,9,13,[15][16][17]19,22,24,32,41,45 were revision procedures. Sixteen studies 4,12,29,31,33,36,39,[43][44][45]47,[49][50][51][52][53] (1058 cases) made no comment regarding whether the procedures were primary or revision cases.…”

“…Sixteen studies 4,12,29,31,33,36,39,[43][44][45]47,[49][50][51][52][53] (1058 cases) made no comment regarding whether the procedures were primary or revision cases. Metallic screw fixation was used in 29 studies, 1,[4][5][6]9,12,13,[15][16][17]19,22,24,29,[31][32][33]36,[42][43][44][45][46][47][49][50][51][52][53] and bioabsorbable screws and plugs were used in 1 study. 39 Repeat surgery was documented in 81 cases (4.9 AE 1.0%), including for hardware problems in 50 and recurrent instability in 20.…”

“…1,[4][5][6]9,12,[15][16][17]19,22,24,29,31,32,36,39,[42][43][44][45][46][47][49][50][51]53 Nerve palsy Taking those 19 studies 1,4,5,9,12,13,[15][16][17]19,24,29,32,36,39,44,47,52,53 that discuss general intraoperative and perioperative complications, the rate of nerve injury identified would be 0.7% (8 of 1069 cases). These included 1 permanent axillary nerve injury treated with a sural nerve graft and 7 transient nerve palsies (1 axillary, 3 musculocutaneous, 2 ulnar and, 1 radial nerve).…”

“…Since these early descriptions of coracoid transfer procedures for shoulder instability, significant interest has been maintained, with numerous modifications to the approach (including arthroscopic techniques) and method of fixation described, although the basic concept has remained the same. 5,7,8,9,12,13,16,22,24,26,39 Understanding the complications associated with these procedures can minimize their occurrence and is important for surgical training and in providing informed consent for patients in whom the operation is planned. The purpose of this study was to conduct a systematic review of the complications of open coracoid transfer procedures to characterize the safety profile for this method of the treatment of anterior shoulder instability.…”

Risk factors for dislocation arthropathy after Latarjet procedure: a long-term study

“…The procedure can be performed open [6,7] or arthroscopically [8,9]. Only a few studies with a large sample size have reported longterm outcomes [10][11][12][13], and only one has focused on dislocation arthropathy as defined by Samilson, which can occur after either shoulder dislocation or surgical repair [14].…”