The Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss

Rossi, Luciano; Tanoira, Ignacio; Bruchmann, María G; Pasqualini, Ignacio; Ranalletta, Maximiliano

doi:10.1177/1758573220944166

Cited by 10 publications

(8 citation statements)

References 35 publications

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“…In terms of patient outcomes, in a recent study of 60 competitive athletes under 20 years old with significant glenoid bone loss who underwent a Latarjet, 93% were able to return to sport and 84% returned to the same level of play. 8-10 Similarly favorable results have been observed in older patients as well. 7,8 In a recent retrospective, single institution study of 190 patients, the 90-day complication rate was 9% and roughly 5% of those complications were graft or hardware failures.…”

Section: Video Transcriptmentioning

confidence: 56%

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Surgical Technique for the Latarjet Procedure Using Non-Cannulated Screws

Nauert

Camp

2023

Video Journal of Sports Medicine

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Background: The Latarjet procedure is effective for patients with anterior glenohumeral instability with substantial glenoid bone loss due to its triple blocking effect. Indications: Indications include high-risk patients with recurrent anterior glenohumeral instability with any glenoid bone loss or low-risk patients with 15% to 30% glenoid bone loss. Technique Description: An incision is made lateral to the coracoid and the deltopectoral interval is established. The pectoralis minor is released medially off the coracoid and the coracoacromial (CA) ligament is released close to the acromion. The coracoid is cut with a right-angle saw and the inferior coracoid is decorticated with a burr. Two holes are pre-drilled in the coracoid. The subscapularis is split between the upper two-thirds and lower one-third with the arm in external rotation. The capsule is split vertically at the joint line and the humeral head is retracted. The anterior glenoid is decorticated with a burr, and a hole is drilled inferiorly. The depth is measured and added to the depth of the inferior bone block hole. A fully threaded 3.5-mm solid stainless steel screw is placed in the inferior hole. Care is taken to ensure that the lateral border of the bone block is flush with the articular margin. This is repeated for the superior hole. A 1.8-mm knotless suture anchor is placed between the screws. The repair stitch is passed through the capsule and loaded onto the anchor and tensioned. The CA ligament is laid over the capsule and repaired. The subscapularis split is repaired side to side and the wound is closed in layers. Results: High return-to-sport rates, including at the same level of play, have been observed among young competitive athletes with significant glenoid bone loss who underwent a Latarjet, with similarly favorable results in older patients. Ninety-day complication rates have been reported around 9%, 5% of which constituted graft or hardware failures. Discussion/Conclusion: The Latarjet procedure is an effective option for indicated patients with anterior glenohumeral instability and may be enhanced with solid screws, proper anatomic technique, and capsulolabral repair augmentation. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

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Section: Video Transcriptmentioning

confidence: 56%

“…7,8 In a recent retrospective, single institution study of 190 patients, the 90-day complication rate was 9% and roughly 5% of those complications were graft or hardware failures. [8][9][10]…”

Section: Video Transcriptmentioning

confidence: 99%

Surgical Technique for the Latarjet Procedure Using Non-Cannulated Screws

Nauert

Camp

2023

Video Journal of Sports Medicine

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“…Reported treatment failure rates after the open Latarjet procedure in adults have been as low as 4%, but literature in adolescents has been scarce [36][37][38][39][40] . The current study confirms that the failure rate is also low in adolescents, who had only 2 failures.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results and Failure Analysis of the Open Latarjet Procedure and Arthroscopic Bankart Repair in Adolescents

Waltenspül

Ernstbrunner

Ackermann

et al. 2022

Journal of Bone and Joint Surgery

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Background: The purpose of this study was to analyze the long-term results of arthroscopic Bankart repair compared with an open Latarjet procedure in adolescents who are at high risk for recurrent anterior shoulder instability. We hypothesized that the long-term stability rate of an open Latarjet procedure would be superior to that of arthroscopic Bankart repair.Methods: Forty eligible patients (41 shoulders) with a mean age of 16.4 years (range, 13 to 18 years) underwent arthroscopic Bankart repair, and 37 patients (40 shoulders) with a mean age of 16.7 years (range, 14 to 18 years) underwent an open Latarjet procedure. Of these, 34 patients (35 shoulders) in the Bankart group and 30 patients (31 shoulders) in the Latarjet group with long-term follow-up were compared; the overall follow-up rate was 82%. Clinical and radiographic results were obtained after a mean follow-up of 12.2 years (range, 8 to 18 years).Results: Treatment failure occurred in 20 shoulders (57%) in the Bankart repair group and in 2 shoulders (6%) in the open Latarjet procedure group (p < 0.001), representing a significantly higher revision rate for instability in the Bankart group (13) compared with the Latarjet group (1) (p < 0.001). In patients without recurrent shoulder instability (15 in the Bankart group and 29 in the Latarjet group), there was a significant improvement in the Constant score (p = 0.006 in the Bankart group and p < 0.001 in the Latarjet group) and Subjective Shoulder Value (p = 0.009 in the Bankart group and p < 0.001 in the Latarjet group), without any significant difference between the 2 groups. Younger age was the only variable significantly correlated with failure following a Bankart repair (p = 0.01).Conclusions: Adolescents are at a high risk for treatment failure after Bankart repair, and, therefore, the Latarjet procedure should be strongly considered as a primary procedure for recurrent anterior shoulder instability in this population.

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“…Two patients in the Latarjet group suffered coracoid process fractures, which are a risk in patients with smaller coracoids, and one patient suffered an axillary nerve palsy. The safety and success of the Latarjet in adolescence is well documented in the broader literature [93][94][95][96]. There is minimal risk of growth disturbances and patients have high rates of return to pre-injury levels of sport, with similar recovery times compared to Bankart repairs [93][94][95][96].…”

Section: Latarjetmentioning

confidence: 99%

“…The safety and success of the Latarjet in adolescence is well documented in the broader literature [93][94][95][96]. There is minimal risk of growth disturbances and patients have high rates of return to pre-injury levels of sport, with similar recovery times compared to Bankart repairs [93][94][95][96].…”

Section: Latarjetmentioning

confidence: 99%

Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population

Rawal,

Eckers,

Lee

et al. 2024

JCM

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Paediatric and adolescent shoulder instability is caused by a unique combination of traumatic factors, ligamentous laxity, and pattern of muscle contractility. The multifactorial nature of its aetiology makes interpretation of the literature difficult as nomenclature is also highly variable. The purpose of this review is to summarize the existing literature and shed light on the nuances of paediatric and adolescent shoulder instability. The epidemiology, clinical features, imaging, and management of all forms of paediatric shoulder instability are presented. The main findings of this review are that structural abnormalities following a dislocation are uncommon in pre-pubertal paediatric patients. Young post-pubertal adolescents are at the highest risk of failure of non-operative management in the setting of traumatic instability with structural abnormality, and early stabilisation should be considered for these patients. Remplissage and the Latarjet procedure are safe treatment options for adolescents at high risk of recurrence, but the side-effect profile should be carefully considered. Patients who suffer from instability due to generalized ligamentous laxity benefit from a structured, long-term physiotherapy regimen, with surgery in the form of arthroscopic plication as a viable last resort. Those who suffer from a predominantly muscle patterning pathology do not benefit from surgery and require focus on regaining neuromuscular control.

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The Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss

Cited by 10 publications

References 35 publications

Surgical Technique for the Latarjet Procedure Using Non-Cannulated Screws

Surgical Technique for the Latarjet Procedure Using Non-Cannulated Screws

Long-Term Results and Failure Analysis of the Open Latarjet Procedure and Arthroscopic Bankart Repair in Adolescents

Current Evidence Regarding Shoulder Instability in the Paediatric and Adolescent Population

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