Failed Latarjet Treated With Full Arthroscopic Eden–Hybinette Procedure Using Two Cortical Suture Buttons Leads to Satisfactory Clinical Outcomes and Low Recurrence Rate

Martínez-Catalán, Natalia; Werthel, Jean‐David; Kazum, Efi; Valenti, Philippe

doi:10.1016/j.arthro.2021.10.026

Cited by 12 publications

(16 citation statements)

References 22 publications

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“…The authors suggest this fixation system in cases where broken hardware is impossible to remove. Martinez-Catalan et al ( 22 ) also published satisfactory results with good glenoid reconstruction in a series of 17 shoulders with critical bone defects. Iliac crest bone graft was incorporated successfully using double suture-button fixation.…”

Section: Bone Grafting Techniquesmentioning

confidence: 92%

“…The results of the arthroscopic technique have also been recently published. (17,19,22) Giannakos et al (17) studied 12 subjects of whom 10 had undergone a previous Latarjet revised with iliac crest bone graft fixed using screws and obtained satisfactory results in 67% of the patients, which was statistically associated with the consolidation of the graft. Boileau et al (19) have also reported the results in a small series of patients using suture-button fixation and demonstrated that the fixation technique is reliable and permits optimal positioning and predictable healing of the new bone graft.…”

Section: Bone Grafting Techniquesmentioning

confidence: 99%

“…The results of the arthroscopic technique have also been recently published. ( 17 , 19 , 22 ) Giannakos et al . ( 17 ) studied 12 subjects of whom 10 had undergone a previous Latarjet revised with iliac crest bone graft fixed using screws and obtained satisfactory results in 67% of the patients, which was statistically associated with the consolidation of the graft.…”

Section: Bone Grafting Techniquesmentioning

confidence: 99%

“…Calvo et al reported 11.8% of cases that remained off-track after undergoing a Latarjet procedure and they had a significantly higher rate of failure than those that converted to ‘on-track’ ( 12 ). In this clinical setting, some authors have suggested the congruent-arc technique as it provides approximately 5 mm more bone augmentation ( 13 ), while others might consider a better option addressing the Hill–Sachs lesion by adding a remplissage to the Latarjet procedure ( 14 ) or to increase the glenoid surface by means of a free bone graft ( 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

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Recurrence of instability after Latarjet procedure: causes, results and treatment algorithm

et al. 2022

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Latarjet modifies the anatomy of the shoulder, and subsequent revision surgery is challenging. It is mandatory to determine the cause of recurrence in order to select the best treatment option. A CT scan is needed to measure glenoid track and evaluate coracoid graft status: position, degree of consolidation, and osteolysis. Conservative management can be advocated in selected patients in whom the instability level does not interfere with the activities they wish to perform. Surgical treatment is based on the glenoid track measurement and coracoid graft suitability. The coracoid graft is considered suitable if it preserves the conjoint tendon insertion, does not show osteolysis, and is large enough to reconstruct the glenoid surface. Adding a remplissage is recommended for those cases with a coracoid graft insufficient to convert large off-track Hill–Sachs lesions into on-track. If the coracoid graft is suitable to reconstruct bone defects in terms of size and viability but is poorly positioned or avulsed, graft repositioning can be a valid option. In patients with unsuitable coracoid bone graft, free bone graft is the revision technique of choice. The size of the graft should be large enough to restore the glenoid surface and to convert any off-track Hill–Sachs lesion into on-track. There is a small group of patients in whom bone defects were properly addressed but Latarjet failed due to hyperlaxity or poor soft tissue quality. Extraarticular capsular reinforcement is suggested in this population.

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Section: Bone Grafting Techniquesmentioning

confidence: 92%

Section: Bone Grafting Techniquesmentioning

confidence: 99%

Section: Bone Grafting Techniquesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Recurrence of instability after Latarjet procedure: causes, results and treatment algorithm

et al. 2022

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“…The Eden-Hybinette procedure has been suggested as a salvage procedure after a failed Latarjet procedure [ 39 ], but also as a primary surgery in patients with subcritical bone loss and reparable soft-tissues [ 56 ] or those with large bone defects not amenable to be reconstructed with the coracoid process bone graft [ 58 ].…”

Section: Glenoid Bone Augmentation Proceduresmentioning

confidence: 99%

Management of off‐track Hill‐Sachs lesions in anterior glenohumeral instability

Calvo

Delgado

2023

J. exp. orthop.

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Bone loss has been identified as a risk factor for recurrent shoulder dislocations or failure after soft tissue repair. Although the range for “critical” bone loss is yet to be determined, glenoid and humeral bone defects should not be regarded as independent problems, but the interaction between them during shoulder motion should be evaluated as suggested by the glenoid track concept. The glenoid track concept is now widely accepted and considered essential for making decisions about surgery. Soft-tissue procedures usually work well in patients with on-track Hill-Sachs lesions but in off-track lesions do not. In this situation additional procedures should be performed.Different surgical options have been described to address off-track Hill-Sachs lesions, most commonly remplissage, Latarjet or free bone block procedures. Coracoid graft and free bone grafts convert the off-track Hill-Sachs lesion into on-track by lengthening the glenoid-track, whereas remplissage fill-in the humeral lesion so that it does not engage. In the setting of a Hill-Sachs lesion with little or no glenoid bone loss, remplissage has demonstrated satisfactory outcomes with a low complications and recurrence rate. Favorable results have been reported with glenoid bone grafting when managing isolated Hill-Sachs or bipolar lesions. Studies analyzing Latarjet and Eden-Hybinette procedures show that both procedures are safe and effective in the management of anterior glenohumeral instability. Attention should be paid to those patients with large bone defects not amenable to be restored with an isolated Latarjet that may be better addressed with an Eden-Hybinnete or adding a remplissage to the Latarjet procedure.

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Three‐dimensional computerized tomography reconstruction‐based morphologic assessment of the coracoid process in an Asian population: Clinical implications for shoulder surgery

Ji,

Yan,

et al. 2024

J. exp. orthop.

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PurposeTo assess coracoid process morphology in an Asian population using three‐dimensional (3D) computed tomography (CT) reconstruction and provide reference values for surgical treatment.MethodsData on demographic and shoulder CT characteristics were collected from 142 patients for 3D‐CT‐based scapular reconstruction. Ten coracoid morphological indicators and the glenoid width were measured. The morphology of the superior pillar and its undersurface were classified into common shapes. Statistical analyses included intraclass correlation coefficient (ICC) analysis, Cohen's κ value, independent samples t test, Welch's t test, Mann–Whitney U test, Kruskal–Wallis test, Spearman and Pearson correlations, receiver operating characteristic (ROC) curves and area under the curve (AUC) values. Relationships among the measured indicators, patient demographics (i.e., sex, age, height and weight) and superior pillar morphology were ascertained.ResultsThe intraobserver and interobserver ICC values were 0.924–0.980 and 0.906–0.962, respectively. For intraobserver and interobserver agreement, Cohen's κ values were 0.927–0.950 and 0.901–0.937, respectively. Significant sex differences in coracoid measurements were noted. Correlations were observed between the coracoid indicators and glenoid width, sex, height and weight (p < 0.05). ROC curve analysis identified height as a significant predictor of safe distance, with cutoff values of 160.5 and 170.5 cm (AUC = 0.82 and 0.83) for women and men, respectively. The superior pillar morphologies included violin (24.65%), long rod (21.13%), short rod (33.80%), trapezoidal (11.97%) and wedge (8.45%) shapes, with the undersurfaces categorized as straight (16.20%), arched (76.76%) and hooked (7.04%), with significant differences in pillar widths among the different morphological types (p < 0.05).ConclusionCoracoid morphology is crucial in the preoperative planning of given shoulder surgeries, with height and sex serving as key predictors of coracoid graft length. Consideration of variations in the superior pillar shape and undersurface of the coracoid could minimize surgical complications associated with special shoulder surgery.Level of EvidenceLevel IV case series with no comparison.

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Failed Latarjet Treated With Full Arthroscopic Eden–Hybinette Procedure Using Two Cortical Suture Buttons Leads to Satisfactory Clinical Outcomes and Low Recurrence Rate

Cited by 12 publications

References 22 publications

Recurrence of instability after Latarjet procedure: causes, results and treatment algorithm

Recurrence of instability after Latarjet procedure: causes, results and treatment algorithm

Management of off‐track Hill‐Sachs lesions in anterior glenohumeral instability

Three‐dimensional computerized tomography reconstruction‐based morphologic assessment of the coracoid process in an Asian population: Clinical implications for shoulder surgery

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