Biomechanical analysis of the modified Bristow procedure for anterior shoulder instability: is the bone block necessary?

Kephart, Curtis J.; Abdulian, Michael H.; McGarry, Michelle H.; Tibone, James E.; Lee, Thay Q.

doi:10.1016/j.jse.2014.03.003

Cited by 30 publications

(21 citation statements)

References 39 publications

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“…This phenomenon has similarly been reported in other biomechanical studies examining the effects of the modified Bristow procedure. 17) While the clinical relevance of this posterior shift is unknown, it may serve as a protective mechanism against anterior subluxation or dislocation of the humeral head in positions of increased abduction and external rotation.…”

Section: Discussionmentioning

confidence: 99%

“…The methods used in this study are similar to those in a previous study evaluating glenohumeral translations of a Bristow compared to a conjoint tendon-only transfer. 17) …”

Section: Methodsmentioning

confidence: 99%

“…An osteotome was used to remove 20% of the anterior glenoid in line with the longitudinal axis. A glenoid lesion of 20% was chosen based on a similar study by Kephart et al 17) …”

Section: Methodsmentioning

confidence: 99%

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Biomechanical Comparison of the Latarjet Procedure with and without Capsular Repair

et al. 2016

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Shoulder instability is a common occurrence in young, physically active individuals. The majority of shoulders dislocate in an anteroinferior direction, resulting in damage to the anteroinferior labrum and glenohumeral ligament.1,2) Repair of the Bankart lesion by both open and arthroscopic methods has shown favorable outcomes regarding stability and the incidence of recurrence.3-5) However, in the setting of significant glenoid bone loss (> 20%), soft tissue reconstructions are universally associated with poor outcomes and unacceptably high recurrence rates. [6][7][8][9] In 1954, Latarjet 10) described transferring the coracoid process with an intact conjoint tendon to the anterior neck of the glenoid in cases of recalcitrant instability due to glenoid bone loss. The stabilizing mechanism of the Latarjet procedure is thought to be provided by both the "bone block" derived from transfer of the coracoid process, which increases the surface area of the anteroinferior glenoid, and the "sling effect" produced by the conjoint tendon and intact subscapularis.11-13) The "sling effect" is especially important in positions of mid to end-range shoulder abduction. 13)Another possible stabilizing mechanism of the Latarjet includes the capsular repair from the transferred

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Section: Discussionmentioning

confidence: 99%

“…The methods used in this study are similar to those in a previous study evaluating glenohumeral translations of a Bristow compared to a conjoint tendon-only transfer. 17) …”

Section: Methodsmentioning

confidence: 99%

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Biomechanical Comparison of the Latarjet Procedure with and without Capsular Repair

et al. 2016

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“… 19 In cases of shoulder instability without severe glenoid defects, a bone block is unnecessary to restore shoulder stability when a sling effect exists. 20 To create a sling effect alone, the Bristow procedure may be indicated 21 because, in this procedure, only the tip of the coracoid process is removed along with the conjoined tendon. However, even in the Bristow procedure described in previous studies, the CA ligament was not protected purposely.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Transfer of the Conjoined Tendon–Coracoid Tip Complex for Anterior Shoulder Instability

Tang

Zhao

2018

Arthroscopy Techniques

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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. The indications for CTCTC transfer are patients younger than 45 years who participate in competitive sports, require forceful external rotation and abduction movements of the shoulder, and/or have capsule-ligament insufficiency. The main steps of this procedure include detaching the CTCTC, fashioning the coracoid tip to obtain a coracoid pillar, braiding the CTCTC, creating a glenoid tunnel and socket, placing a guide suture through the glenoid tunnel and subscapularis, passing the CTCTC through the subscapularis and into the glenoid socket, and performing suspension fixation of the CTCTC.

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“… 19 In cases of shoulder instability without severe glenoid defect, a bone block is unnecessary to restore shoulder stability when a sling effect exists. 20 To create a sling effect alone, the Bristow procedure may be indicated 21 because in this procedure only the tip of the coracoid process is removed along with the conjoined tendon. However, even in the Bristow procedure, caution should be taken regarding the length of the coracoid process to be removed.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Transfer of the Long Head of the Biceps Brachii for Anterior Shoulder Instability

Tang

Zhao

2017

Arthroscopy Techniques

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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). The main steps of this procedure include detaching the LHB, retrieving and braiding the LHB, creating a glenoid tunnel, placing a guide suture through the subscapularis and glenoid tunnel, passing the LHB through the subscapularis and into the glenoid tunnel, and suspension fixation of the LHB.

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Biomechanical analysis of the modified Bristow procedure for anterior shoulder instability: is the bone block necessary?

Cited by 30 publications

References 39 publications

Biomechanical Comparison of the Latarjet Procedure with and without Capsular Repair

Biomechanical Comparison of the Latarjet Procedure with and without Capsular Repair

Arthroscopic Transfer of the Conjoined Tendon–Coracoid Tip Complex for Anterior Shoulder Instability

Arthroscopic Transfer of the Long Head of the Biceps Brachii for Anterior Shoulder Instability

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