Latarjet Cerclage: The Metal-Free Fixation

Abstract

The Latarjet technique is a widely used technique for anterior shoulder instability with glenoid bone defects, irreparable capsuloligamentous lesion, or in patients at greater risk of recurrence. The use of this technique has been reported to obtain satisfactory clinical and biomechanical results. Although other methods exist, the coracoid process is typically fixed with 2 metal screws. Complications related to metal fixation are very frequently reported. In an attempt to avoid these complications, we developed this arthroscopically assisted metal-free Latarjet technique in which we fix a coracoid graft using four cerclage tapes to achieve a strong, stable fixation, thus mimicking a plate.

Modified Arthroscopic Latarjet Procedure: Button Fixation Without Splitting of the Subscapularis

“…In contrast, portal E is less important for creating bone tunnels from posterior to anterior directions. 25 However, our method has two main limitations. First, carrying out this procedure while undertaking a Bankart repair simultaneously is difficult.…”

“…In contrast, portal E is less important for creating bone tunnels from posterior to anterior directions. 25 …”

Latarjet Cerclage: The All-Arthroscopic Metal-Free Fixation

“…39,40 In fact, the use of only one cortical button could facilitate the rotation around the button, which could lead to a compromised the graft-healing process. 41 We recently described an arthroscopically assisted Latarjet procedure without metal implants: The Latarjet Cerclage technique, 20 in this technique, we used 4 highstrength suture tapes through a 2.4-mm tunnels, with an outbound journey and inbound journey, configuring them in a circle, connecting both tunnels with the same tapes, achieving a strong fixation construct, mimicking a compression plate between the coracoid process and the glenoid. This configuration seems stronger than a parallel independent double fixation suspensory system and could improve bone graft healing.…”

“…[17][18][19] We recently described an arthroscopically assisted Latarjet procedure without metal implants: The Latarjet Cerclage technique. 20 Afterwards, we have been able to develop our metal-free fixation technique in a completely arthroscopic manner. In this Technical Note, we present our all-arthroscopic Latarjet cerclage technique, a completely arthroscopic metal-free fixation method using 2 ultra-high-strength sutures with an additional capsulolabral complex reconstruction.…”

Open Latarjet with Metal-Free Cerclage Fixation

“… 9 This metal-free coracoid cerclage fixation using a mini-open approach can provide a safe and effective construct and avoids metal-induced and neurologic complications associated with the traditional procedure. 11 , 12 …”