10 Years of Arthroscopic Latarjet Procedure: Outcome and Complications

Meraner, Dominik; Smolen, Daniel; Sternberg, Christoph; Thallinger, Christoph; Hahne, Julia; Leuzinger, Jan

doi:10.4103/ortho.ijortho_273_17

Cited by 15 publications

(19 citation statements)

References 36 publications

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“…A common belief is that the suture button suspensory system is a “nonrigid fixation system.” 21,32 The use of the tensioning device rigidifies the suture fixation construct and eliminates micromotion. This tensioner allows for transforming of the flexible suture button construct into a bolt (or a rivet), providing a rigid fixation with intraoperative bone block compression.…”

Section: Discussionmentioning

confidence: 99%

“…29,40,41,43 Although mechanically effective, 22,26,33 screw fixation remains a major source of complications (up to 30%) and the main reason for revision surgery and hardware removal (up to 7%). 2,14,17,20,22,24,32,36 Despite providing stable fixation, metal screws have been associated with severe hardware 24,36 and neurological 18,20-22 complications. Additionally, screw trajectory and positioning of the graft flush to the glenoid surface are challenging when performing an arthroscopic approach using a “freehand” technique.…”

mentioning

confidence: 99%

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Arthroscopic Latarjet: 2 or 4 Cortical Buttons for Coracoid Fixation? A Case-Control Comparative Study

Barret¹,

Chelli²,

Meijden³

et al. 2022

Am J Sports Med

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Background: While 2 screws are traditionally used for coracoid bone block fixation, no gold standard technique has yet been established when using cortical buttons. Purpose: To compare anatomic and clinical outcomes of the arthroscopic Latarjet procedure using either 2 or 4 buttons for coracoid bone block fixation. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 23 patients with 4-button fixation (group 4B) were matched for age at surgery, sex, and follow-up to 46 patients who had 2-button fixation (group 2B). All patients underwent guided arthroscopic Latarjet (using coracoid and glenoid guides), and a tensioning device was used to rigidify the suture button construct and get intraoperative bone block compression. The primary outcome was assessment of bone block positioning and healing using computed tomography scans performed at 2 weeks and at least 6 months after surgery. The mean ± standard deviation follow-up was 49 ± 7 months (range, 24-64 months). Results: The bone block healing rate was similar in both groups: 91% in group 4B versus 95.5% in group 2B. The transferred coracoid was flush to the glenoid surface in 21 patients (91%) in group 4B and 44 patients (96%) in group 2B ( P = .6); it was under the equator in 22 patients (96%) in group 4B and 44 patients (96%) in group 2B ( P≥ .99). There was no secondary bone block displacement; the rate of bone block resorption was similar between the groups: 28% in group 4B and 23% in group 2B ( P = .71). Patient-reported outcomes, return to sports, and satisfaction were also similar between the groups. The operating time was significantly longer in group 4B (95 vs 75 minutes; P = .009). Conclusion: A 4-button fixation technique did not demonstrate any anatomic or clinical advantages when compared with a 2-button fixation technique, while making the procedure more complex and lengthening the operating time by 20 minutes. A 2-button fixation is simple, safe, and sufficient to solidly fix the transferred coracoid bone block. The use of drill guides allows accurate graft placement, while the use of a tensioning device to rigidify the suture button construct provides high rates of bone block healing with both techniques (>90%).

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Arthroscopic Latarjet: 2 or 4 Cortical Buttons for Coracoid Fixation? A Case-Control Comparative Study

Barret¹,

Chelli²,

Meijden³

et al. 2022

Am J Sports Med

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“…Short-term evaluations of the arthroscopic coracoid transfer report recurrence rates ranging from 0 to 6.1% [ 1 , 6 , 7 , 10 , 13 , 26 , 27 , 51 ]. Dumont et al [ 14 ] published mid- to long-term outcomes of 62 patients with a mean follow-up of 76.4 months and observed recurrent subluxations in one patient (1.6%).…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic iliac crest bone grafting in recurrent anterior shoulder instability: minimum 5-year clinical and radiologic follow-up

Boehm

Minkus

Moroder

2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To investigate the clinical and radiologic mid-to long-term results of arthroscopic iliac crest bone-grafting for anatomic glenoid reconstruction in patients with recurrent anterior shoulder instability. Methods Seventeen patients were evaluated after a minimum follow-up of 5 years. Clinical [range of motion, subscapularis tests, apprehension sign, Subjective Shoulder Value (SSV), Constant Score (CS), Rowe Score (RS), Walch Duplay Score (WD), Western Ontario Shoulder Instability Index (WOSI)], and radiologic [X-ray (true a.p., Bernageau and axillary views) and computed tomography (CT)] outcome parameters were assessed. Results Fourteen patients [mean age 31.1 (range 18-50) years] were available after a follow-up period of 78.7 (range 60-110) months. The SSV averaged 87 (range 65-100) %, CS 94 (range 83-100) points, RS 89 (range 30-100) points, WD 87 (range 25-100) points, and WOSI 70 (range 47-87) %. The apprehension sign was positive in two patients (14%). One patient required an arthroscopic capsular plication due to a persisting feeling of instability, while the second patient experienced recurrent dislocations after a trauma, but refused revision surgery. CT imaging showed a significant increase of the glenoid index from preoperative 0.8 ± 0.04 (range 0.7-0.8) to 1.0 ± 0.11 (range 0.8-1.2) at the final follow-up (p < 0.01). Conclusion Arthroscopic reconstruction of anteroinferior glenoid defects using an autologous iliac crest bone-grafting technique yields satisfying clinical and radiologic results after a mid-to long-term follow-up period. Postoperative re-dislocation was experienced in one (7.1%) of the patients due to a trauma and an anatomic reconstruction of the pear-shaped glenoid configuration was observed. Level of evidence IV.

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“…Therapy options include repair of soft tissue defects (labral and capsular structures) as well as bony defects (glenoid bone loss or Hill-Sachs lesions), depending on the extent of the damage [6]. Various studies have shown satisfying clinical and radiological outcome after arthroscopic Bankart repair [7,8], Latarjet procedure [9][10][11] or free bone-grafting techniques [6,12,13] and patients show improved quality of life after Bankart repair [14]. The primary goal of surgical therapy options is to re-establish stability and many surgeons measure the success after shoulder stabilization surgery only by the absence of re-dislocation.…”

Section: Introductionmentioning

confidence: 99%

Differences in Patients’ and Surgeons’ Expectations before Shoulder Stabilization Surgery

Karpinski

Plachel

Gerhardt

et al. 2021

JCM

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Purpose: The primary goal of shoulder stabilization procedures is to re-establish stability and many surgeons measure the success after shoulder stabilization surgery only by the absence of re-dislocation. However, patients might also suffer from pain, loss of range of motion and strength as well as anxiety and stigmatization and therefore have other expectations from a stabilization surgery than just a stable shoulder. Purpose of this study was to analyze if surgeons know what their patients typically expect from a shoulder stabilization surgery. Furthermore, the aim was to analyze the influence of various factors on patients’ expectations. Materials and Methods: 204 patients with a diagnosis of shoulder instability scheduled for surgical treatment were included in this prospective multicentric study. Preoperatively, objective and subjective scores were obtained and patients were asked about their postoperative expectations. Additionally, 25 surgeons were interviewed with regard to what they think their patients expect from the surgery using standardized questions. Results: With regard to postoperative expectations surveyed by the Hospital for Special Surgery questionnaire (HSS), the most important goal to achieve for the patients was ‘stopping the shoulder from dislocation’, followed by ‘to improve the ability to exercise or participate in sports’ and ‘being the shoulder to be back the way it was before the issue started’. The ranking of factors for patients was ‘stability’ as the most important to achieve, followed by ‘movement’, ‘strength’, ‘pain’ and ‘cosmetics’. For surgeons, the order was ‘stability’ (p = 0.004 **), ‘movement’ (p = 0.225), ‘pain’ (p = 0.509), ‘strength’ (p = 0.007 **) and ‘cosmetics’ (p = 0.181). There was a significant difference between patients and surgeons with regard to gaining stability at the cost of movement (p = 0.001 **). Conclusion: Patients and surgeons expectations regarding outcome after surgical shoulder stabilization procedures are quite similar with limited topics of disagreement. Generally, surgeons tend to overrate the importance of stability at the costs of other factors.

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10 Years of Arthroscopic Latarjet Procedure: Outcome and Complications

Cited by 15 publications

References 36 publications

Arthroscopic Latarjet: 2 or 4 Cortical Buttons for Coracoid Fixation? A Case-Control Comparative Study

Arthroscopic Latarjet: 2 or 4 Cortical Buttons for Coracoid Fixation? A Case-Control Comparative Study

Arthroscopic iliac crest bone grafting in recurrent anterior shoulder instability: minimum 5-year clinical and radiologic follow-up

Differences in Patients’ and Surgeons’ Expectations before Shoulder Stabilization Surgery

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