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Ettore Taverna, Vincenzo Guarrella, Roberto Cartolari, Henri Ufenast, Laura Broffoni, Christophe Barea, Guido Garavaglia
Background: The effectiveness of the Latarjet largely depends on accurate graft placement, as well as on proper position and direction of the screws. We present our technique for an arthroscopically-assisted Latarjet comparing radiological results with the open technique. Methods: We retrospectively reviewed the postoperative computed tomography scans of 38 patients who underwent a Latarjet procedure. For 16 patients, the procedure was performed with the open technique and, for 22 patients, it was performed using an arthroscopically-assisted technique...
April 2018: Shoulder & Elbow
Nuno Rui Paulino Pereira, Just A van der Linde, Hassanin Alkaduhimi, Umile Giuseppe Longo, Michel P J van den Bekerom
Background: The primary aim of the present study was to review, summarize and compare the redislocation risk for collision athletes and noncollision athletes after an open Bristow-Latarjet procedure. Our secondary aim was to summarize return to sport, satisfaction, pain and complications. Methods: We conducted a systematic review in PubMed and EMBASE of articles until 1 July 2016. We included all studies describing Bristow-Latarjet like procedures as a result of glenohumeral instability, mentioning redislocation rates in collision athletes with >2 years of follow-up...
April 2018: Shoulder & Elbow
Eoghan T Hurley, Daren Lim Fat, Shane K Farrington, Hannan Mullett
BACKGROUND: Anterior shoulder instability with significant glenoid bone loss is a challenging condition. The open Latarjet procedure is the established standard treatment method in this setting, but there is an increasing use of the arthroscopic technique. PURPOSE: To systematically review the current evidence in the literature to ascertain if the open or arthroscopic Latarjet procedure resulted in improved patient outcomes. STUDY DESIGN: Systematic review and meta-analysis...
March 1, 2018: American Journal of Sports Medicine
David M Privitera, Nathan J Sinz, Lindsay R Miller, Elana J Siegel, Muriel J Solberg, Stephen D Daniels, Laurence D Higgins
BACKGROUND: Few studies have evaluated the success of the Latarjet procedure for recurrent anterior glenohumeral instability in the contact or collision athlete. The purpose of this study was to evaluate the return-to-sport and functional results of the Latarjet procedure in this select group. METHODS: One hundred and nine consecutive contact or collision athletes (112 shoulders) treated with an open Latarjet procedure for recurrent anterior glenohumeral instability were retrospectively identified...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Philippe Collin, Alexandre Lädermann
Anteroinferior glenohumeral instability can be treated by variants of the Bankart repair, remplissage , and the Latarjet procedure, although all options remain associated with complications, including recurrence, stiffness, persistent pain, apprehension, and dislocation arthropathy. The authors therefore thought of a concept of dynamic anterior stabilization to treat anteroinferior glenohumeral instability by transferring the long head of the biceps within a subscapularis split to the anterior glenoid margin, thereby creating a "sling effect" by using a conservative technique...
January 2018: Arthroscopy Techniques
Jin Tang, Jinzhong Zhao
In the treatment of anterior shoulder instability, there are various conditions in which a sling effect is needed to enhance anterior stability. The traditional Bristow-Latarjet procedure provides a sling effect but destroys or does not purposely protect the coracoacromial (CA) arch, which may result in superior instability. To preserve the CA arch and create a sling to enhance the anterior-inferior side of the shoulder, we introduce an arthroscopic technique to transfer the conjoined tendon-coracoid tip complex (CTCTC) with the intention to keep the CA ligament intact to the utmost...
January 2018: Arthroscopy Techniques
Mohammad Samim, Kirstin M Small, Laurence D Higgins
BACKGROUND: The goal of the Latarjet procedure is restoration of shoulder stability enabled by accurate graft positioning and union. This study aimed to establish a reproducible method of quantitatively assessing coracoid graft osseous union percentage (OUP) using computed tomography (CT) scans and to determine the effect of other factors on the OUP. MATERIALS AND METHODS: Postoperative CT scans of 41 consecutive patients treated with the open Latarjet procedure (37% primary, 63% revision) for anterior glenohumeral instability were analyzed for the OUP, position of the graft, and screw type and angle...
February 21, 2018: Journal of Shoulder and Elbow Surgery
Joseph W Galvin, Josef K Eichinger, Eric J Cotter, Alyssa R Greenhouse, Stephen A Parada, Brian R Waterman
Purpose: The purpose of this study is to evaluate the trends in surgical management for anterior shoulder instability in the U.S. Military. Methods: A retrospective analysis of military service members undergoing arthroscopic or open shoulder stabilization from 2012 to 2015 within the U.S. Military Health System was conducted. Demographic and surgical variables were extracted from the medical record. Chi-square and linear regression analysis were performed to identify temporal trends by surgical procedures and concomitant surgery...
February 6, 2018: Military Medicine
Jin Tang, Jinzhong Zhao
In the treatment of anterior shoulder instability, there are various conditions in which a sling effect is needed to enhance anterior stability. The traditional Latarjet procedure provides a sling effect but destroys the coracoacromial arch, which may result in superior instability. To preserve the coracoacromial arch and create a sling to enhance the anterior-inferior side of the shoulder, we introduce an arthroscopic technique to transfer the long head of the biceps (LHB) brachii. Indications of LHB transfer are patients younger than 45 years of age who participate in competitive sports, require forceful external rotation and abduction movement of the shoulder, and/or have capsule-ligament insufficiency, as well as patients 45 years o or older who have combined SLAP lesions (type II or IV)...
October 2017: Arthroscopy Techniques
Matthew T Provencher
Arthroscopic techniques are an emerging technology to deal with glenoid bone defects in patients with anterior shoulder instability, and improvements are being made to safely minimize the risk of injury to the anterior neurovascular structures including the axillary nerve. Arthroscopic glenoid reconstruction is a technically demanding procedure, but it does have promising short-term outcomes. I truly like the concept of anterior (and also posterior) bone grafting for defects of the glenoid, including the arthroscopic Latarjet...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Maximiliano Ranalletta, Luciano A Rossi, Agustin Bertona, Ignacio Tanoira, Gastón D Maignon, Santiago L Bongiovanni
PURPOSE: To analyze time to return to sport, functional outcomes, and recurrences of the modified Latarjet procedure without capsulolabral repair in athletes with recurrent anterior shoulder instability after a failed previous operative stabilization. METHODS: We included athletes with recurrent anterior shoulder instability with a previous failed operative stabilization treated with the modified Latarjet procedure without capsulolabral repair with a minimum of 2-year follow-up...
February 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Nicolas de l'Escalopier, Olivier Barbier, Thomas Demoures, Didier Ollat, Gilbert Versier
Introduction: Stabilizing surgery of the shoulder with a coracoid graft according to Latarjet is a recognized surgical treatment for anterior instability of the shoulder. This pathology frequently affects soldiers. Postoperatively, the potential risk of recurrence or of secondary shoulder arthritis can limit the practitioner in their ability assessment. The aim of this study is to analyze the long-term outcomes of this surgery in a military population, in order to assess the possible implications for French soldiers' medical ability...
January 1, 2018: Military Medicine
David Saliken, Vincent Lavoué, Christophe Trojani, Jean-François Gonzalez, Pascal Boileau
Patients presenting with recurrent shoulder instability and bipolar glenohumeral bone loss are at risk of failed standard soft-tissue repair techniques. Even isolated bony-stabilization procedures such as the Latarjet or remplissage technique may not provide sufficient stability in the face of combined bone loss. We use a combined all-arthroscopic remplissage, Latarjet, and Bankart repair for patients with significant combined glenohumeral bone loss and/or in the revision setting. This allows reconstruction of both the Hill-Sachs and glenoid bone defects and repair of the capsulolabral complex in a minimally invasive manner...
October 2017: Arthroscopy Techniques
Jorge Chahla, Daniel Cole Marchetti, Gilbert Moatshe, Márcio B Ferrari, George Sanchez, Alex W Brady, Jonas Pogorzelski, George F Lebus, Peter J Millett, Robert F LaPrade, Matthew T Provencher
PURPOSE: To perform a quantitative anatomic evaluation of the (1) coracoid process, specifically the attachment sites of the conjoint tendon, the pectoralis minor, the coracoacromial ligament (CAL), and the coracoclavicular (CC) ligaments in relation to pertinent osseous and soft tissue landmarks; (2) CC ligaments' attachments on the clavicle; and (3) CAL attachment on the acromion in relation to surgically relevant anatomic landmarks to assist in planning of the Latarjet procedure, acromioclavicular (AC) joint reconstructions, and CAL resection distances avoiding iatrogenic injury to surrounding structures...
January 24, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Rachel M Frank, Anthony A Romeo, Catherine Richardson, Shelby Sumner, Nikhil N Verma, Brian J Cole, Gregory P Nicholson, Matthew T Provencher
BACKGROUND: Anterior glenoid reconstruction with fresh distal tibia allograft (DTA) has been described for management of recurrent shoulder instability, with encouraging early outcomes; however, no comparative data with the Latarjet procedure are available. PURPOSE: The purpose of this study was to compare the clinical outcomes between patients undergoing DTA and a matched cohort of patients undergoing Latarjet. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
Adam Kwapisz, Kelly Fitzpatrick, Jay B Cook, George S Athwal, John M Tokish
BACKGROUND: Bone loss in shoulder instability is a well-recognized cause of failure after stabilization surgery. Many approaches have been described to address glenoid bone loss, including coracoid transfer. This transfer can be technically difficult and has been associated with high complication rates. An ideal alternative to coracoid transfer would be an autologous source of fresh osteochondral graft with enough surface area to replace significant glenoid bone loss. The distal clavicle potentially provides such a graft source that is readily available and low-cost...
January 1, 2018: American Journal of Sports Medicine
Kellie C Huxel Bliven, Gail P Parr
Reference/Citation:  An VV, Sivakumar BS, Phan K, Trantalis J. A systematic review and meta-analysis of clinical and patient-reported outcomes following two procedures for recurrent traumatic anterior instability of the shoulder: Latarjet procedure vs. Bankart repair. J Shoulder Elbow Surg. 2016;25(5):853-863. CLINICAL QUESTION:   Are clinical and patient-reported outcomes different between the Latarjet and Bankart repair stabilization procedures when performed for recurrent traumatic anterior shoulder instability? DATA SOURCES:   Ovid MEDLINE, PubMed, Cochrane databases, American College of Physicians Journal Club, and Database of Abstracts of Review of Effectiveness were searched up to June 2015...
January 19, 2018: Journal of Athletic Training
Nicolas Bonnevialle, Charles Edouard Thélu, Yves Bouju, Jérôme Vogels, Charles Agout, Pauline Duriez, Vadim Azoulay
BACKGROUND: The arthroscopic Latarjet with double-button fixation is a guided procedure recently proposed to treat anterior shoulder instability with glenoid bone loss. The goal of this study was to report intraoperative and early postoperative complications and to analyze the learning curve. METHODS: This was a prospective, nonrandomized study that included 88 patients. Intraoperative or postoperative complications as well as adverse events and operative time were recorded...
January 12, 2018: Journal of Shoulder and Elbow Surgery
A Lädermann, E Böhm, E Tay, M Scheibel
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...
January 15, 2018: Der Orthopäde
Uli Schmiddem, Nael Hawi, Emmanouil Liodakis, Antonios Dratzidis, Manuel Kraemer, Christof Hurschler, Richard Page, Rupert Meller
PURPOSE: A crucial step of the Latarjet procedure is the fixation of the coracoid process onto the glenoid. Multiple problems associated with the fixation have been described, including lesions of the suprascapular nerve due to prominence of the screw or bicortical drilling. The purpose of the present study was to evaluate whether monocortical fixation, without perforating the posterior glenoid cortex, would provide sufficient graft stability. METHODS: Coracoid transfer was performed in 14 scapula models (Sawbones®, Composite Scapula, 4th generation)...
January 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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