Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 2, pp 513–520 | Cite as

Biomechanical comparison of the Latarjet procedure with and without a coracoid bone block

  • W. Barrett Payne
  • Matthew T. Kleiner
  • Michelle H. McGarry
  • James E. Tibone
  • Thay Q. Lee



The aim of this study was to biomechanically evaluate the Latarjet procedure, with and without a bone block, on glenohumeral range of motion, translation, and kinematics after creation of a bony Bankart lesion.


Eight cadaveric shoulders were tested for range of motion, translation, and kinematics in 90° shoulder abduction in both the scapular and coronal planes with the following conditions: intact, Bankart lesion with 20 % glenoid bone loss, Latarjet procedure and soft tissue only conjoined tendon transfer.


There was a significant increase in range of motion in both the scapular and coronal planes with both the Latarjet and conjoined tendon transfer compared to the intact state. The Latarjet procedure restored anterior and inferior translation in both planes. The conjoined tendon transfer restored anterior and inferior translation at lower translational loads, but not with higher loads. Both reconstructions shifted the humeral head apex posteriorly in external rotation.


The increase in range of motion suggests that the Latarjet procedure does not initially over-constrain the joint. At higher loads, there was improved stability with the Latarjet procedure compared to the conjoint tendon transfer. Both Latarjet and conjoined tendon transfer procedures alter normal joint kinematics by shifting the humeral head apex posteriorly in external rotation.


Instability Bony Bankart Glenoid bone loss Latarjet Conjoined tendon Cadaver Study Kinematics 



Partial funding provided by VA Rehabilitation Research and Development Merit Review and the John C. Griswold Foundation. The funding source did not play a role in the investigation.


  1. 1.
    Allain J, Goutallier D, Glorion C (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80(6):841–852PubMedGoogle Scholar
  2. 2.
    Bankart AS (1923) Recurrent or habitual dislocation of the shoulder-joint. Br Med J 2(3285):1132–1133PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Bessiere C, Trojani C, Carles M, Mehta SS, Boileau P (2014) The open Latarjet procedure is more reliable in terms of shoulder stability than arthroscopic Bankart repair. Clin Orthop Relat Res 472(8):2345–2351PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Bhatia S, Frank RM, Ghodadra NS, Hsu AR, Romeo AA, Bach BR Jr, Boileau P, Provencher MT (2014) The outcomes and surgical techniques of the Latarjet procedure. Arthroscopy 30(2):227–235CrossRefPubMedGoogle Scholar
  5. 5.
    Bigliani LU, Newton PM, Steinmann SP, Connor PM, McLlveen SJ (1998) Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med 26(1):41–45PubMedGoogle Scholar
  6. 6.
    Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16(7):677–694CrossRefPubMedGoogle Scholar
  7. 7.
    Cho NS, Yoo JH, Rhee YG (2015) Management of an engaging Hill–Sachs lesion: arthroscopic remplissage with Bankart repair versus Latarjet procedure. Knee Surg Sports Traumatol Arthrosc [Epub ahead of print]Google Scholar
  8. 8.
    Dumont GD, Fogerty S, Rosso C, Lafosse L (2014) The arthroscopic Latarjet procedure for anterior shoulder instability: 5 year minimum follow-up. Am J Sports Med 42(11):2560–2566CrossRefPubMedGoogle Scholar
  9. 9.
    Giles JW, Boons HW, Elkinson I, Faber KJ, Ferreira LM, Johnson JA, Athwal GS (2013) Does the dynamic sling effect of the Latarjet procedure improve shoulder stability? A biomechanical evaluation. J Shoulder Elbow Surg 22(6):821–827CrossRefPubMedGoogle Scholar
  10. 10.
    Giles JW, Boons HW, Ferreira LM, Johnson JA, Athwal GS (2011) The effect of the conjoined tendon of the short head of the biceps and coracobrachialis on shoulder stability and kinematics during in vitro simulation. J Biomech 44(6):1192–1195CrossRefPubMedGoogle Scholar
  11. 11.
    Hill JA, Lombardo SJ, Kerlan RK, Jobe FW, Carter VS, Shields CL Jr, Collins HR, Yocum LA (1981) The modification Bristow-Helfet procedure for recurrent anterior shoulder subluxations and dislocations. Am J Sports Med 9(5):283–287CrossRefPubMedGoogle Scholar
  12. 12.
    Hovelius L, Korner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berg E (1983) The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure. J Bone Joint Surg Am 65(7):926–934PubMedGoogle Scholar
  13. 13.
    Hovelius L, Sandstrom B, Olofsson A, Svensson O, Rahme H (2012) The effect of capsular repair, bone block healing, and position on the results of the Bristow-Latarjet procedure (study III): long-term follow-up in 319 shoulders. J Shoulder Elbow Surg 21(5):647–660CrossRefPubMedGoogle Scholar
  14. 14.
    Hovelius L, Vikerfors O, Olofsson A, Svensson O, Rahme H (2011) Bristow-Latarjet and Bankart: a comparative study of shoulder stabilization in 185 shoulders during a seventeen-year follow-up. J Shoulder Elbow Surg 20(7):1095–1101CrossRefPubMedGoogle Scholar
  15. 15.
    Itoi E, Lee SB, Berglund LJ, Berge LL, An KN (2000) The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 82(1):35–46PubMedGoogle Scholar
  16. 16.
    Kephart CJ, Abdulian MH, McGarry MH, Tibone JE, Lee TQ (2014) Biomechanical analysis of the modified Bristow procedure for anterior shoulder instability: is the bone block necessary? J Shoulder Elbow Surg 23(12):1792–1799CrossRefPubMedGoogle Scholar
  17. 17.
    Kuhn JE, Bey MJ, Huston LJ, Blasier RB, Soslowsky LJ (2000) Ligamentous restraints to external rotation of the humerus in the late-cocking phase of throwing. A cadaveric biomechanical investigation. Am J Sports Med 28(2):200–205PubMedGoogle Scholar
  18. 18.
    Kuhn JE, Huston LJ, Soslowsky LJ, Shyr Y, Blasier RB (2005) External rotation of the glenohumeral joint: ligament restraints and muscle effects in the neutral and abducted positions. J Shoulder Elbow Surg 14(1 Suppl S):39S–48SCrossRefPubMedGoogle Scholar
  19. 19.
    Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49(8):994–997PubMedGoogle Scholar
  20. 20.
    Lee YS, Lee TQ (2010) Specimen-specific method for quantifying glenohumeral joint kinematics. Ann Biomed Eng 38(10):3226–3236PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Mizuno N, Denard PJ, Raiss P, Melis B, Walch G (2014) Long-term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elbow Surg 23(11):1691–1699CrossRefPubMedGoogle Scholar
  22. 22.
    Piasecki DP, Verma NN, Romeo AA, Levine WN, Bach BR Jr, Provencher MT (2009) Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management. J Am Acad Orthop Surg 17(8):482–493PubMedGoogle Scholar
  23. 23.
    Porcellini G, Campi F, Pegreffi F, Castagna A, Paladini P (2009) Predisposing factors for recurrent shoulder dislocation after arthroscopic treatment. J Bone Joint Surg Am 91(11):2537–2542CrossRefPubMedGoogle Scholar
  24. 24.
    Provencher MT, Bhatia S, Ghodadra NS, Grumet RC, Bach BR Jr, Dewing CB, LeClere L, Romeo AA (2010) Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am 92(Suppl):2133–2151Google Scholar
  25. 25.
    Saito H, Itoi E, Sugaya H, Minagawa H, Yamamoto N, Tuoheti Y (2005) Location of the glenoid defect in shoulders with recurrent anterior dislocation. Am J Sports Med 33(6):889–893CrossRefPubMedGoogle Scholar
  26. 26.
    Thomas PR, Parks BG, Douoguih WA (2010) Anterior shoulder instability with Bristow procedure versus conjoined tendon transfer alone in a simple soft-tissue model. Arthroscopy 26(9):1189–1194CrossRefPubMedGoogle Scholar
  27. 27.
    Veeger HE, Van der Helm FC, Van der Woude LH, Pronk GM, Rozendal RH (1991) Inertia and muscle contraction parameters for musculoskeletal modelling of the shoulder mechanism. J Biomech 24(7):615–629CrossRefPubMedGoogle Scholar
  28. 28.
    Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, Cordasco FA, Allen AA, Service HSSSM (2010) Prospective evaluation of arthroscopic Bankart repairs for anterior instability. Am J Sports Med 38(2):302–307CrossRefPubMedGoogle Scholar
  29. 29.
    Walch G, Boileau P (2000) Latarjet-Bristow procedure for recurrent anterior instability. Tech Shoulder Elbow Surg 1:256–261CrossRefGoogle Scholar
  30. 30.
    Wellmann M, de Ferrari H, Smith T, Petersen W, Siebert CH, Agneskirchner JD, Hurschler C (2012) Biomechanical investigation of the stabilization principle of the Latarjet procedure. Arch Orthop Trauma Surg 132(3):377–386CrossRefPubMedGoogle Scholar
  31. 31.
    Wellmann M, Petersen W, Zantop T, Herbort M, Kobbe P, Raschke MJ, Hurschler C (2009) Open shoulder repair of osseous glenoid defects: biomechanical effectiveness of the Latarjet procedure versus a contoured structural bone graft. Am J Sports Med 37(1):87–94CrossRefPubMedGoogle Scholar
  32. 32.
    Yamamoto N, Muraki T, An KN, Sperling JW, Cofield RH, Itoi E, Walch G, Steinmann SP (2013) The stabilizing mechanism of the Latarjet procedure: a cadaveric study. J Bone Joint Surg Am 95(15):1390–1397CrossRefPubMedGoogle Scholar
  33. 33.
    Young AA, Maia R, Berhouet J, Walch G (2011) Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint. J Shoulder Elbow Surg 20(2 Suppl):S61–S69CrossRefPubMedGoogle Scholar
  34. 34.
    Young DC, Rockwood CA Jr (1991) Complications of a failed Bristow procedure and their management. J Bone Joint Surg Am 73(7):969–981PubMedGoogle Scholar
  35. 35.
    Zuckerman JD, Matsen FA 3rd (1984) Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg Am 66(2):175–180PubMedGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) (outside the USA) 2015

Authors and Affiliations

  • W. Barrett Payne
    • 1
  • Matthew T. Kleiner
    • 1
  • Michelle H. McGarry
    • 2
  • James E. Tibone
    • 1
  • Thay Q. Lee
    • 2
    • 3
    • 4
  1. 1.Department of Orthopaedic Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Orthopaedic Biomechanics LaboratoryVA Long Beach Healthcare SystemLong BeachUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of CaliforniaIrvineUSA
  4. 4.Department of Biomedical EngineeringUniversity of CaliforniaIrvineUSA

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