Results of the Latarjet coracoid bone block procedure performed by mini invasive approach
- 115 Downloads
The coracoid block technique described by Latarjet was modified by Patte and Walch in order to increase the glenoid surface. Saragaglia further modified this technique and described a minimally invasive approach which allows faster post-operative recovery. The aim of this study was to evaluate the medium-term functional and radiological results of this technique.
This is a single surgeon cohort of 40 shoulders in 38 patients (32 men, 6 women) with an average age of 34.5 years operated on between January and December 2014. The skin incision was 3 to 6 cm long allowing the bony block to be passed under the subscapularis tendon without sectioning it and to be placed in lying position. The bone block was fixed with a 6.5 cancellous screw or a 7.0 cannulated screw.
At an average follow-up of 48 months, there were no recurrent dislocations. The average WOSI score was 42, the average Constant score was 95 corrected to 97% and the average SSV was 97. Visual analogue scores were 0 at rest and 0.6 with activity. The bone block healed in 92.5% of cases. It was flush with the edge of the glenoid in 84% of cases, lateralised in 10% and medialised in 6% of cases. Mean internal rotation power was 12 kg in the operated shoulder compared with 9 kg in the non-operated shoulder.
The treatment of recurrent anterior shoulder instability by mini invasive Latarjet gives excellent medium-term functional results. The rate of recurrent dislocation in this series was zero and internal rotation power was well preserved. This is an excellent alternative to arthroscopic procedures which are yet to demonstrate their superiority over open surgery.
KeywordsAnterior shoulder dislocations Latarjet Bone block Mini invasive approach
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
- 4.Burkhart SS, De Beer JF, Barth JRH et al (2007) Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 23:1033–1041. https://doi.org/10.1016/j.arthro.2007.08.009 CrossRefGoogle Scholar
- 6.Levigne C (2000) Long-term results of anterior coracoid abutments: apropos of 52 cases with homogenous 12-year follow-up. Rev Chir Orthopédique Réparatrice Appar Mot 86(Suppl 1):114–121Google Scholar
- 8.Metais P, Clavert P, Barth J et al (2016) Preliminary clinical outcomes of Latarjet-Patte coracoid transfer by arthroscopy vs. open surgery: prospective multicentre study of 390 cases. Orthop Traumatol Surg Res OTSR 102:S271–S276. https://doi.org/10.1016/j.otsr.2016.08.003 CrossRefPubMedGoogle Scholar
- 13.Pichon H, Startun V, Barthelemy R, Saragaglia D (2008) Comparative study of the anatomic and clinical effect of Weaver or subtotal subscapularis tendon section in Latarjet procedure. Rev Chir Orthop Reparatrice Appar Mot 94:12–18. https://doi.org/10.1016/j.rco.2007.10.007 CrossRefPubMedGoogle Scholar
- 16.Jouve F, Graveleau N, Nové-Josserand L, Walch G (2008) Recurrent anterior instability of the shoulder associated with full thickness rotator cuff tear: results of surgical treatment. Rev Chir Orthop Reparatrice Appar Mot 94:659–669. https://doi.org/10.1016/j.rco.2008.03.032 CrossRefPubMedGoogle Scholar