High rate of return to sport and excellent patient-reported outcomes after an open Latarjet procedure

Ernat, Justin J.; Rakowski, Dylan R.; Hanson, Jared A.; Casp, Aaron; Lee, Simon; Peebles, Annalise M.; Horan, Marilee P.; Provencher, Matthew T.; Millett, Peter J.

doi:10.1016/j.jse.2022.01.139

Cited by 19 publications

(14 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further, the patient reported outcomes measured by the ASES and WOSI scores in our study were favourable and similar to those reported in previous literature. 11,12 This study does have limitations. First, the time point for the assessment of postoperative strength varied between patients.…”

Section: Caubere Et Al Described a Series Of 20 Patients After Openmentioning

confidence: 96%

Strength after the arthroscopic Latarjet procedure: Are shoulder internal rotation, elbow flexion & supination strength decreased?

Alnusif

Lari²,

Al-Qahtani

et al. 2023

Shoulder & Elbow

View full text Add to dashboard Cite

Background The Latarjet procedure is an effective shoulder stabilizing surgery, however, the procedure results in an alteration of anatomy that may result in shoulder and elbow weakness. Thus, the purpose of this study was to assess post-operative shoulder and elbow strength after the Latarjet procedure. We hypothesized that shoulder and elbow strength are not affected after the procedure. Methods The study group consisted of patients that had undergone the arthroscopic Latarjet procedure. An isokinetic dynamometer was used to evaluate the strength of bilateral shoulder internal rotation, elbow flexion, forearm supination using peak torque (N/m), as well as grip strength (kilograms). Shoulder range of motion and the potential effects of hand dominance were further analysed. Results Nineteen patients with a mean age of 29 years and an average follow up of 47 months were included. Shoulder internal rotation strength, elbow flexion and forearm supination strength and grip strength were not significantly different when compared to the non-operative side ( p > 0.13). The range of shoulder external rotation was significantly reduced ( p < 0.001) on the Latarjet side. Conclusion The results from this study demonstrate no statistically significant differences in the strength of shoulder internal rotation, elbow flexion, forearm supination or grip strength despite the surgical alterations to the subscapularis and conjoint tendon.

show abstract

Section: Caubere Et Al Described a Series Of 20 Patients After Openmentioning

confidence: 96%

Strength after the arthroscopic Latarjet procedure: Are shoulder internal rotation, elbow flexion & supination strength decreased?

Alnusif

Lari²,

Al-Qahtani

et al. 2023

Shoulder & Elbow

View full text Add to dashboard Cite

show abstract

“…It provides a triple blocking effect to increase anterior shoulder stability, and this has been well described in the literature. [1][2][3][4][5][6] Although the indications vary from surgeon to surgeon, we typically consider Latarjet for high-risk patients for recurrent instability who have any glenoid bone loss or low-risk patients who have between 15% and 30% anterior glenoid bone loss. 3,7 For those lower risk patients with \15% glenoid bone loss, we typically perform an Surgical Techniques arthroscopic stabilization procedure.…”

Section: Video Transcriptmentioning

confidence: 99%

Surgical Technique for the Latarjet Procedure Using Non-Cannulated Screws

Nauert

Camp

2023

Video Journal of Sports Medicine

View full text Add to dashboard Cite

Background: The Latarjet procedure is effective for patients with anterior glenohumeral instability with substantial glenoid bone loss due to its triple blocking effect. Indications: Indications include high-risk patients with recurrent anterior glenohumeral instability with any glenoid bone loss or low-risk patients with 15% to 30% glenoid bone loss. Technique Description: An incision is made lateral to the coracoid and the deltopectoral interval is established. The pectoralis minor is released medially off the coracoid and the coracoacromial (CA) ligament is released close to the acromion. The coracoid is cut with a right-angle saw and the inferior coracoid is decorticated with a burr. Two holes are pre-drilled in the coracoid. The subscapularis is split between the upper two-thirds and lower one-third with the arm in external rotation. The capsule is split vertically at the joint line and the humeral head is retracted. The anterior glenoid is decorticated with a burr, and a hole is drilled inferiorly. The depth is measured and added to the depth of the inferior bone block hole. A fully threaded 3.5-mm solid stainless steel screw is placed in the inferior hole. Care is taken to ensure that the lateral border of the bone block is flush with the articular margin. This is repeated for the superior hole. A 1.8-mm knotless suture anchor is placed between the screws. The repair stitch is passed through the capsule and loaded onto the anchor and tensioned. The CA ligament is laid over the capsule and repaired. The subscapularis split is repaired side to side and the wound is closed in layers. Results: High return-to-sport rates, including at the same level of play, have been observed among young competitive athletes with significant glenoid bone loss who underwent a Latarjet, with similarly favorable results in older patients. Ninety-day complication rates have been reported around 9%, 5% of which constituted graft or hardware failures. Discussion/Conclusion: The Latarjet procedure is an effective option for indicated patients with anterior glenohumeral instability and may be enhanced with solid screws, proper anatomic technique, and capsulolabral repair augmentation. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

show abstract

“…The development of small-diameter, all-suture anchors allows for the placement of more anchors, resulting in additional fixation points for a potentially more robust repair. In the small percentage of patients who do have subsequent instability, the ability to perform a revision Latarjet procedure is maintained, with good outcomes 5 . Ernat et al recently reported no difference in failure rates or patient outcomes in revision compared with primary Latarjet procedures 5 , in contrast to the results of this study.…”

Section: Commentarymentioning

confidence: 99%

“…In the small percentage of patients who do have subsequent instability, the ability to perform a revision Latarjet procedure is maintained, with good outcomes 5 . Ernat et al recently reported no difference in failure rates or patient outcomes in revision compared with primary Latarjet procedures 5 , in contrast to the results of this study. In cases in which patients are high-level or collision athletes or have more severe bone loss with an off-track lesion, we commonly will perform a primary Latarjet procedure 2 .…”

Section: Commentarymentioning

confidence: 99%

Primary Latarjet for Anterior Shoulder Instability in Adolescents: An Unstable Conclusion

Hanson

Foster

Pearce

et al. 2022

Journal of Bone and Joint Surgery

Self Cite

View full text Add to dashboard Cite

Anterior shoulder instability is a common pathology, particularly among active adolescents. In recent decades, our understanding of anterior shoulder instability and its management has evolved, with more emphasis on osseous abnormalities of the glenoid and humeral head, multidirectional instability, and patient factors that increase the risk of recurrence 1 . Although the arthroscopic Bankart repair is often considered the first-line treatment for anterior shoulder instability, concerns regarding high failure rates exist, specifically in younger patients and/or those with >15% glenoid bone loss 1 . The Latarjet procedure, which functions to improve stability by increasing the glenoid width and by using the sling effect, is often considered an effective treatment option in these cases 2 . As a result of the complexity of many of the factors that contribute to anterior shoulder instability, optimal surgical management remains controversial.We commend Waltenspül et al. for their long-term retrospective analysis of adolescents who underwent an arthroscopic Bankart repair or an open Latarjet procedure for the treatment of recurrent anterior shoulder instability. In their study, with failure defined as redislocation or persistent anterior apprehension, the authors reported failure rates of 57% for arthroscopic Bankart repair and 6% for open Latarjet procedures. This led the authors to conclude that surgeons should consider the open Latarjet procedure for primary treatment of recurrent anterior shoulder instability in adolescents. These results are in contradiction to most other studies on arthroscopic Bankart repair. Although the high failure rate is concerning, it is important to recognize the methodological limitations of the study, as it was not appropriately designed to compare the 2 treatments. Preoperatively there were significant differences in group characteristics, and there was limited discussion of indications for Bankart repair, raising major concerns for selection bias. Additionally, there are concerns about the technical aspects of the arthroscopic repairs and the experience of the surgeons performing them. Included Bankart repairs utilized a mean of 3 anchors, but as few as only 1 anchor. The number of anchors, in conjunction with the utilization of anchors of an outdated design, may indicate inadequate fixation and the use of improper surgical technique 3 . Finally, the study included 81 total cases compiled from 12 surgeons over a 10-year period, raising substantial concerns with regard to surgeon volume and its relationship to the reported outcomes.Although we undoubtedly agree that, in specific circumstances, the Latarjet procedure is a superior option to the arthroscopic Bankart repair, it must be recognized that proceeding with a nonanatomic procedure is a nuanced decision that is not without risk 2 . This choice is complicated further in the adolescent population given their potential need for a future surgical procedure on a nonnative shoulder, the inherently smaller size of the coracoid in a gro...

show abstract

High rate of return to sport and excellent patient-reported outcomes after an open Latarjet procedure

Cited by 19 publications

References 33 publications

Strength after the arthroscopic Latarjet procedure: Are shoulder internal rotation, elbow flexion & supination strength decreased?

Strength after the arthroscopic Latarjet procedure: Are shoulder internal rotation, elbow flexion & supination strength decreased?

Surgical Technique for the Latarjet Procedure Using Non-Cannulated Screws

Primary Latarjet for Anterior Shoulder Instability in Adolescents: An Unstable Conclusion

Contact Info

Product

Resources

About