Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint

Young, Allan; Maia, Roberto; Berhouet, Julien; Walch, Gilles

doi:10.1016/j.jse.2010.07.022

Cited by 229 publications

(223 citation statements)

References 23 publications

(25 reference statements)

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“…Multiple stabilisation procedures have been developed in recent years [1][2][3][4][5][6][7], including open or arthroscopic Bankart repairs (with or without capsular shifts) and bone block procedures.…”

Section: Introductionmentioning

confidence: 99%

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Raiss

Zeifang

Pons-Villanueva

et al. 2014

International Orthopaedics (SICOT)

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Purpose Osteoarthritis in combination with rotator cuff deficiency following previous shoulder stabilisation surgery and after failed surgical treatment for chronic anterior shoulder dislocation is a challenging condition. The aim of this study was to analyse the results of reverse shoulder arthroplasty in such patients. Methods Thirteen patients with a median follow-up of 3.5 (range two to eight) years and a median age of 70 (range 48-82) years were included. In all shoulders a tear of at least one rotator cuff tendon in combination with osteoarthritis was present at the time of arthroplasty. The Constant score, shoulder flexion and external and internal rotation with the elbow at the side were documented pre-operatively and at the final follow-up. Pre-operative, immediate post-operative and final follow-up radiographs were analysed. All complications and revisions were documented. Results Twelve patients were either satisfied or very satisfied with the procedure. The median Constant score increased from 26 points pre-operatively to 67 points at the final follow-up (p=0.001). The median shoulder flexion increased significantly from 70°to 130°and internal rotation from two to four points (p=0.002). External rotation did not change significantly (p=0.55). Glenoid notching was present in five cases and was graded as mild in three cases and moderate in two. One complication occurred leading to revision surgery. Conclusions Reverse arthroplasty leads to high satisfaction rates for patients with osteoarthritis and rotator cuff deficiency who had undergone previous shoulder stabilisation procedures. The improvements in clinical outcome as well as the radiographic results seem to be comparable with those of other studies reporting on the outcome of reverse shoulder arthroplasty for other conditions.

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Section: Introductionmentioning

confidence: 99%

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Raiss

Zeifang

Pons-Villanueva

et al. 2014

International Orthopaedics (SICOT)

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“…The Latarjet procedure [1] and its subsequent modifications [2,3] are becoming increasingly popular and are currently considered as an efficient method to stabilise the shoulder primarily or after recurrent dislocation [4,5]. The procedure can be performed open [6,7] or arthroscopically [8,9].…”

Section: Introductionmentioning

confidence: 99%

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

Lädermann

Lübbeke

Stern

et al. 2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to analyse the longterm incidence of dislocation arthropathy after a modified Latarjet procedure for glenohumeral instability. Methods Long-term follow-up information was obtained from a consecutive series of patients who had undergone a modified Latarjet procedure by one surgeon between 1986 and 1999. Multivariable regression analysis was performed to examine the relation between the development of a dislocation arthropathy and patients and surgery-related factors. Results There were 117 patients (117 shoulders) for evaluation, (35 women and 82 men) with a mean age 28.4±8.5 (range, 16-55). The mean follow-up was 16.2 years (range, ten to 22.2 years). Signs of dislocation arthropathy were found in 36 % of patients, graded as Samilson 1 in 30 %, Samilson 2 in 3 %, and 3 % Samilson 3 in 3 % of patients. Risk factors for dislocation arthropathy included surgery in patients older than 40 years of age (64.3 vs. 34.4 %; adjusted RR 2.2, 95 % CI 1.7-2.9) and lateral positioning of the transferred coracoid process in relation to the glenoid rim (82.4 vs. 30.4 %; adjusted RR 2.3, 95 % CI 1.7-3.2). Patients with hyperlaxity developed less dislocation arthropathy (15 vs. 42.5 %; adjusted RR 0.4, 95 % CI 0.1-0.95). Conclusion The development of dislocation arthropathy after the Latarjet procedure remains a source of concern in the long term. It correlates with surgery after the age of 40 and lateral coracoid transfer in relation to the glenoid rim. On the other hand, hyperlaxity seems to have a protective effect on the development of dislocation arthropathy.

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“…However, Didier Patte modified the original Latarjet procedure to fix the coracoid in the lying down position with two screws and also explained the triple blocking effect of the grafted bone [6] . Gilles Walch further pioneered the procedure by fixing the coracoid with two malleolar screws, which are 4.5 mm in diameter and partially threaded [2] . Thus it is desirable to osteotomize as big a size of coracoid as possible.…”

Section: Discussionmentioning

confidence: 99%

“…The indications for Latarjet include glenoid bone loss and / or big hill sachs defect. However, for many surgeons in Europe it is a primary procedure of choice to treat anterior instability, irrespective of the bone loss [2] . The procedure includes osteotomizing the coracoid at its base, mobilizing it along with the conjoint tendon and fixing it medially on the glenoid with the help of two screws [2] .…”

Section: Introductionmentioning

confidence: 99%

“…However, for many surgeons in Europe it is a primary procedure of choice to treat anterior instability, irrespective of the bone loss [2] . The procedure includes osteotomizing the coracoid at its base, mobilizing it along with the conjoint tendon and fixing it medially on the glenoid with the help of two screws [2] . This is done by first removing the coraco-acromial ligament and the pectoralis minor tendon and then osteotomizing the coracoid at the base but sparing the coracoclavicular ligaments.…”

Section: Introductionmentioning

confidence: 99%

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2017

Int. J. Orthop. Sci.

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Background: Latarjet procedure is frequently done to treat shoulder instability. It includes osteotomizing the coracoid distal to the insertion of coracoclavicular ligament. Knowledge of the insertion of the trapezoid ligament is important to determine the level of coracoid osteotomy. Methods: Ten shoulders were dissected free of overlying soft tissue while preserving the ligament and muscle attachment on the coracoid. The distance between the tip of the coracoid to the coracoclavicular ligament and the pectoralis minor insertion width on the coracoid was measured. Result: The average distance from the tip of the coracoid to the trapezoid insertion was 2.6 cm. The average pectoralis minor insertion width was 1.9 cm. Conclusion: To preserve the insertion of the trapezoid ligament, the coracoid should be osteotomized less than 2.6 cm from the tip of the coracoid.

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Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint

Cited by 229 publications

References 23 publications

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

Reverse arthroplasty for osteoarthritis and rotator cuff deficiency after previous surgery for recurrent anterior shoulder instability

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

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