Modified Latarjet Procedure Without Capsulolabral Repair for the Treatment of Failed Previous Operative Stabilizations in Athletes

Ranalletta, Maximiliano; Rossi, Luciano; Bertona, Agustín; Tanoira, Ignacio; Maignon, Gastón; Bongiovanni, Santiago

doi:10.1016/j.arthro.2017.12.006

Cited by 34 publications

(35 citation statements)

References 21 publications

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“…Partial lysis of the coracoid occurs frequently but only rarely leads to persistent apprehension and unsatisfactory outcomes, and no specific management is required unless too proud and/or symptomatic metalwork. 16 , 17 , 18 …”

Section: Discussionmentioning

confidence: 99%

Modified Latarjet Procedure Without Capsulolabral Repair for Failed Previous Operative Stabilizations

Ranalletta

Bertona

Tanoira

et al. 2018

Arthroscopy Techniques

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The optimal management of recurrent anterior shoulder instability with significant glenoid bone loss continues to be a challenge. The high recurrence rates seen in arthroscopic Bankart repair in the presence of significant glenoid bone loss have led many surgeons to choose bony reconstructions to manage these injuries. The Latarjet procedure acts through the combination of 3 different mechanisms: the coracoid bone graft restores and extends the glenoid articular arc, the conjoint tendon acts as a dynamic sling on the inferior subscapularis and anteroinferior capsule when the arm is abducted and externally rotated, and the effect of repairing the capsule to the stump of the coracoacromial ligament. However, in patients with multiple recurrences and previous surgeries, the anteroinferior labrum and capsule are often very deficient or practically destroyed. This Technical Note provides a detailed description of the modified Latarjet procedure without capsulolabral repair for patients with failed previous operative stabilizations.

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Section: Discussionmentioning

confidence: 99%

Modified Latarjet Procedure Without Capsulolabral Repair for Failed Previous Operative Stabilizations

Ranalletta

Bertona

Tanoira

et al. 2018

Arthroscopy Techniques

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“…The senior author, Dr. Ranalletta, and his associates have written extensively on their vast experience with the congruent-arc Latarjet procedure. In a previous study of 68 athletes undergoing this procedure after failed stabilization, Ranalletta et al 18 reported no recurrent subluxations or dislocations, with a reoperation rate of 3% and graft-healing rate of 92%. Moreover, in a study of 100 athletes, including overhead, contact, and collision athletes, they reported no recurrent instability, with a graft-healing rate of 91% and return-to-sport rate of 96%, including a 91% rate of return to the preinjury level of play.…”

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confidence: 95%

“…Ó 2020 by the Arthroscopy Association of North America 0749-8063/201058/$36.00 https://doi.org/10.1016/j.arthro.2020.06.030 similar restoration of joint stability with the classic and congruent-arc techniques. 14 Numerous reports have highlighted the excellent clinical results with both the classic [15][16][17] and congruentarc 5,[18][19][20] techniques. However, despite the substantial interest in understanding the anatomic and biomechanical differences between the classic and congruent-arc techniques, there has been a dearth of clinical comparative study.…”

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confidence: 99%

Editorial Commentary: Classic and Congruent-Arc Latarjet Techniques Are Equally Safe and Effective Procedures, so Choose Whichever Technique Works Best in Your Hands for Your Patients

Hasan¹

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The classic and congruent-arc Latarjet techniques are equally safe and effective in restoring glenohumeral stability, even when performed as a revision of a failed stabilization. The classic technique provides a broader contact area for healing and facilitates and improves screw fixation. The congruent-arc technique theoretically optimizes glenohumeral contact forces because of the matched radius of curvature, provides better restoration of glenoid depth, and restores larger glenoid defects. However, rotating the coracoid graft for the congruent-arc technique eliminates the possibility of imbricating the coracoacromial ligament stump to the capsule. Surgeons have little reason to change from one technique to the other; both techniques result in successful outcomes.

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“…12,13 Furthermore, the Latarjet procedure is increasingly being considered as the treatment of choice for contact athletes and military personnel who are at high risk of recurrent instability, even with small amounts of glenoid bone loss. [14][15][16][17] The robust bone block and additional soft tissueestabilizing mechanisms of the "sling effect" 18 provided by the Latarjet allow these athletes to return sports requiring high functional demands of their shoulders.…”

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confidence: 99%

Latarjet Procedure With Coracoclavicular Ligament Augmentation for Traumatic Coracoid Fracture and Recurrent Anterior Glenohumeral Instability in an Elite Contact Athlete

Tanghe

Peebles

Ridley

et al. 2020

Arthroscopy Techniques

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Coracoid fractures are relatively uncommon injuries and are typically treated conservatively or with open reduction and internal fixation of displaced fractures. In rare cases, coracoid fractures coincide with glenohumeral instability. Although glenohumeral instability is frequently treated with Bankart procedures, the Latarjet procedure (or transfer of the coracoid process) is used in patients with significant glenoid bone loss, recurrent instability, or prior failed Bankart procedures. However, in some cases, surgeons opt for the Latarjet procedure in patients who are at risk for recurrent instability, such as the elite contact athlete presented in this case. This Technical Note describes the transfer of a previously fractured coracoid fragment to the anterior glenoid rather than reduction of the fracture with concurrent coracoclavicular ligament augmentation to restore anterior shoulder stability.

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Modified Latarjet Procedure Without Capsulolabral Repair for the Treatment of Failed Previous Operative Stabilizations in Athletes

Cited by 34 publications

References 21 publications

Modified Latarjet Procedure Without Capsulolabral Repair for Failed Previous Operative Stabilizations

Modified Latarjet Procedure Without Capsulolabral Repair for Failed Previous Operative Stabilizations

Editorial Commentary: Classic and Congruent-Arc Latarjet Techniques Are Equally Safe and Effective Procedures, so Choose Whichever Technique Works Best in Your Hands for Your Patients

Latarjet Procedure With Coracoclavicular Ligament Augmentation for Traumatic Coracoid Fracture and Recurrent Anterior Glenohumeral Instability in an Elite Contact Athlete

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