Is the subscapularis normal after the open Latarjet procedure? An isokinetic and magnetic resonance imaging evaluation

Caubère, Alexandre; Lami, Damien; Boileau, Pascal; Parratte, Sébastien; Ollivier, Matthieu; Argenson, Jean-Noël

doi:10.1016/j.jse.2017.03.034

Cited by 30 publications

(45 citation statements)

References 21 publications

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“…12 Regarding subscapularis structural integrity, other authors did not find any cases of atrophy, tear, or fatty degeneration. 5 In our study, on the other hand, we observed that the upper subscapularis demonstrated lower MMA than the inferior subscapularis and infraspinatus/teres minor. This difference might be reasonably attributed to the more accurate quantitative method of measurement used in the present investigation.…”

Section: Discussioncontrasting

confidence: 42%

“…Caubêre et al found similar results in a series of 20 patients who underwent an open Latarjet procedure. 5 They also described a decrease in the internal and external rotation strength when compared with the healthy shoulder but not in the peak agonistantagonist ratio of the operated arm. This could indicate that in the operated arm, the external rotator function is also decreased in postoperative evaluation.…”

Section: Discussionmentioning

confidence: 96%

“…In spite of satisfactory clinical and radiographic results, 4,29 one of the disadvantages of Latarjet is the potential dysfunction of the subscapularis muscle owing to atrophy, fatty degeneration, or tearing. 5,11,39 The arthroscopic technique could increase these risks because of the specific difficulties in some of the surgical steps, such as the subscapularis split and graft positioning. 9 Consequences of subscapularis split had been widely studied in the context of open instability surgeries and open Latarjet.…”

Section: Discussionmentioning

confidence: 99%

“…9 Consequences of subscapularis split had been widely studied in the context of open instability surgeries and open Latarjet. 5,[11][12][13]17,[36][37][38][39] However, outcomes of arthroscopic subscapularis split are still relatively unknown. This is the first study on the clinical, radiologic, and isokinetic performance of the subscapularis after arthroscopic Latarjet procedure at long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…33 Function of the subscapularis muscle has been widely studied after total shoulder replacements, open capsular shifts, Bankart repair, and more recently after open Latarjet procedures. 2,5,11,12,17,31,36,38,40 In Bristow-Latarjet procedures, subscapularis tenotomy seems to be related to weakness of the muscle confirmed by means of an isokinetic study. On the other hand, the outcomes of the splitting technique are controversial.…”

mentioning

confidence: 92%

See 4 more Smart Citations

Subscapularis structural integrity and function after arthroscopic Latarjet procedure at a minimum 2-year follow-up

Valencia

Fernández-Bermejo

Martín-Ríos

et al. 2020

Journal of Shoulder and Elbow Surgery

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Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 92%

See 3 more Smart Citations

Subscapularis structural integrity and function after arthroscopic Latarjet procedure at a minimum 2-year follow-up

Valencia

Fernández-Bermejo

Martín-Ríos

et al. 2020

Journal of Shoulder and Elbow Surgery

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The moment arms and lines of action of subscapularis after the Latarjet procedure

Fox,

Ernstbrunner,

Henze

et al. 2024

Journal Orthopaedic Research

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The Latarjet procedure is an established surgical treatment for recurrent glenohumeral joint instability with glenoid bone loss. Intraoperatively, the conjoint tendon is routed through a split in subscapularis to the coracoid bone graft, which is fixed to and augments the anteroinferior glenoid. The objective of this in vitro study was to quantify the influence of glenohumeral joint position and conjoint tendon force on the lines of action and moment arms of subscapularis muscle sub‐regions after Latarjet surgery. Eight fresh‐frozen, entire upper extremities were mounted onto a testing apparatus, and a cable system used to apply physiological muscle loading to the major shoulder muscles. The lines of action and moment arms of four sub‐regions of subscapularis (superior, mid‐superior, mid‐inferior, and inferior) were quantified radiographically with the conjoint tendon unloaded and loaded while the shoulder was in (i) 0° abduction (ii) 90° abduction (iii) 90° abduction and full external rotation (ABER), and (iv) the apprehension position, defined as ABER with 30° horizontal extension. Conjoint tendon loading after Latarjet surgery significantly increased the inferior inclination of the lines of action of the mid‐inferior and inferior sub‐regions of subscapularis in the scapular plane in ABER and apprehension positions (p<0.001), as well as decreased the horizontal flexion moment arm of the inferior subscapularis (p=0.040). Increased subscapularis inferior inclination may ultimately increase inferior joint shear potential, while smaller horizontal flexion leverage may reduce joint flexion capacity. The findings have implications for Latarjet surgical planning and post‐operative rehabilitation prescription.This article is protected by copyright. All rights reserved.

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Bone-mediated anteroinferior glenohumeral instability

et al. 2018

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Recurrent anterior shoulder instability is commonly associated with defects of the anterior glenoid rim. Substantial osseous defects significantly diminish the glenohumeral stability and require a bony augmentation, either by a coracoid transfer or free bone grafting procedure. Both reconstructive techniques have been applied for a long time and evaluated biomechanically and clinically. Although neither treatment option has been recognized as clearly superior, both comprise certain advantages and disadvantages. The Latarjet technique enables a biomechanically superior stabilization through the additional sling effect at time zero, but constitutes an extra-anatomical procedure with a broad spectrum and relatively high incidence of complications. Free bone grafting techniques enable an anatomical reconstruction of the glenoid concavity, offer the advantage of an unlimited graft size and show generally less severe and more easily manageable complications. The indications need to be carefully considered depending on the specific defect type, the glenoid track concept in cases of bipolar lesions as well as the individual patient characteristics. For both reconstructive procedures, open and arthroscopic approaches have been described with very good results, allowing a selection based on individual surgical skills and experience levels.

show abstract

Is the subscapularis normal after the open Latarjet procedure? An isokinetic and magnetic resonance imaging evaluation

Cited by 30 publications

References 21 publications

Subscapularis structural integrity and function after arthroscopic Latarjet procedure at a minimum 2-year follow-up

Subscapularis structural integrity and function after arthroscopic Latarjet procedure at a minimum 2-year follow-up

The moment arms and lines of action of subscapularis after the Latarjet procedure

Bone-mediated anteroinferior glenohumeral instability

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