Arthroscopic Management of Anterior Glenoid Bone Loss

Lemmex, Devin B.; Cárdenas, Gabriel; Ricks, Matthew; Woodmass, Jarret M.; Chelli, Mikaël; Boileau, Pascal

doi:10.2106/jbjs.rvw.19.00049

Cited by 18 publications

(12 citation statements)

References 118 publications

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“…The Latarjet procedure was first published more than 60 years ago and since its first description, many modifications have been described. 21 However, it was indeed professor Gilles Walch who popularized it as the most effective treatment and standard of care for recurrent anterior shoulder instabilities with anterior glenoid bone defect, humeral head defect, or bipolar lesions, with several reported good long-term results. 2,22e24 It has been performed typically through an open approach, although there is currently a trend to perform it arthroscopically.…”

Section: Discussionmentioning

confidence: 99%

Latarjet Cerclage: The All-Arthroscopic Metal-Free Fixation

Hachem

Ríus

et al. 2021

Arthroscopy Techniques

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The BristoweLatarjet procedure has been one of the most recognized procedures for the treatment of recurrent shoulder dislocation with anterior glenoid bone loss, revision surgery after failed Bankart repair, contact and collision sport injuries, and patients with a high risk of recurrence. Open and arthroscopic approaches have recently shown similar outcomes by several authors. However, complications related to metal implants, despite being low, are still a matter of concern. We describe an all-arthroscopic Latarjet technique with a metal-free fixation method using 2 ultra-high-strength sutures, creating a cerclage construct through 2.4mm glenoid and coracoid tunnels with a final capsulolabral complex reconstruction.

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Section: Discussionmentioning

confidence: 99%

Latarjet Cerclage: The All-Arthroscopic Metal-Free Fixation

Hachem

Ríus

et al. 2021

Arthroscopy Techniques

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“…Не дивлячись на те, що ефект «гамака» ймовірно відіграє найважливішу роль у механізмі стабілізації з поміж інших зазначених [2], варіативність операції за Латарже здебільшого визначається положенням і центруванням дзьобоподібного виростка [3,4] включаючи внутрішньо-та позасуглобове розміщення, методи фіксації кісткового блока [5][6][7][8] з відновленням або без капсульногубних структур, а також артроскопічні техніки проведення операції за Латарже [9][10][11]. У свою чергу, це обумовлено тим, що положення кісткового трансплантата і спосіб його фіксації впливають на ризик розвитку рецидиву, віддаленні результати операції та можливі ускладнення [12].…”

Section: вступunclassified

Mathematical Modeling of Graft Fixation Variants to the Anterior Margin of the Glenoid Performing Latarjet Procedure

Golovakha¹,

Kuznietsov²,

Karpinsky³

et al. 2021

OTP

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Latarjet procedure is a common standard in the treatment of anterior and anterior-inferior shoulder instability with a significant glenoid defect. However, like any other surgical technique, it has a list of certain intra- and postoperative complications, including mistakes in the positioning of the bone block. A necessary guarantee of prevention and reduction of the frequency of possible complications associated with graft positioning is a well-performedpreoperative planning with an understanding of the biomechanical functioning of the shoulder joint with the translated bone block. Objective. According to the mathematical modelling we studied the changes that occur in the stress-strain state of the shoulder joint model depending on the options for graft fixation and may occur during the Latarjet procedure. Methods. To solve this problem, a finite element model of the shoulder was created. The simulationswere performed using the SolidWorks computer-aided design system. The following situations were simulated: variants of fixing screws relative to the plane of the articular surface of the glenoid (parallel to the plane, at an angle of 10° and 20°) and variants of graft fixation height at the anterior edge of the glenoid (at the lower edge of the glenoid, 10 mm and 20 mm upper edge). Calculations of the stress-strain state of the models were performed with the CosmosM software package. Results and conclusions. The presence of a bone graft fixed with metal screws at the area of the defect at the anterior edge of the glenoid, leads to an increase in stress levels in the bone elements of the model. Changes in the stress-strain state of the shoulder model also occur, depending on the angle of the screws that secure the graft. The highest stress level was determined when providing the fixing screws at an angle of 10°, the lowest — when providing the screws parallel to the articular surface of the glenoid. The stresses on the locking screws increased slightly with increasing angle of the screws. When studying the height of graft fixation, the most favorable option, in terms of stress distribution on the articular surface of the glenoid and fixing screws, is its location in the lower part of the anterior edge of the glenoid.

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“…Larger degrees of glenoid bone loss or failure of arthroscopic procedures may warrant more involved surgeries, such as anterior bone block reconstruction or Latarjet procedures. 1…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of shoulder instability procedures: A comprehensive analysis of complications and costs

et al. 2022

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Background Recurrent shoulder instability is a debilitating condition that can lead to chronic pain, decreased function, and inability to return to activities or sport. This retrospective epidemiology study was performed to report 90-day postoperative complications and costs of Latarjet, anterior bone block reconstruction, arthroscopic, and open Bankart repair for shoulder instability. Methods Patients 18 years and older who underwent four primary shoulder surgeries from 2010 to 2019 were identified using national claims data. Patient demographics, comorbidities, and 90-day postoperative complications were analyzed using univariate analysis and multivariable logistic regression. Total and itemized 90-day reimbursements were determined for each procedure. Results The 90-day medical and surgery-specific complication rates were highest for anterior bone block reconstruction, followed by Latarjet. Arthroscopic Bankart repair had the highest 90-day costs and primary procedure costs compared to other procedures. Conclusion Anterior bone block reconstruction and Latarjet procedures were associated with the highest rates of 90-day medical and surgery-specific complications, while arthroscopic Bankart repair was associated with the highest costs.

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Arthroscopic Management of Anterior Glenoid Bone Loss

Cited by 18 publications

References 118 publications

Latarjet Cerclage: The All-Arthroscopic Metal-Free Fixation

Latarjet Cerclage: The All-Arthroscopic Metal-Free Fixation

Mathematical Modeling of Graft Fixation Variants to the Anterior Margin of the Glenoid Performing Latarjet Procedure

Epidemiology of shoulder instability procedures: A comprehensive analysis of complications and costs

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