The results of the boytchev procedure for treatment of recurrent dislocation of the shoulder

Stabilizing effect of the transferred conjoined tendon on shoulder stability

“…Although clinical results of the Boytchev procedure or the modified Boytchev procedure for the treatment of recurrent anterior glenohumeral instability were controversial [7–9, 12, 29], our study clearly demonstrated the biomechanical benefits of these procedures. The conjoined tendon per se has a stabilizing effect on stable and unstable shoulders, and the conjoined tendon in situ can provide its stronger stabilizing function for the unstable shoulder when the tendon per se is more powerful.…”

“…Several authors reported their excellent clinical results of the modified Boytchev procedure for the treatment of recurrent anterior dislocation of the shoulder [7, 8, 12], and they believed that this technique was sound biomechanically. The rerouted conjoined tendon pulls the subscapularis forward during elevation of the shoulder, thus increasing the lever arm and augmenting the internal rotational moment arm.…”

“…This technique involves rerouting of the coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis) along with the pectoralis minor muscle deep to the subscapularis and reattachment to its anatomical location. Later Conforty [8] modified this procedure by using the conjoined tendon of the short head of biceps and coracobrachialis only rather than the pectoralis minor muscle. They believed that the rerouted conjoined tendon should provide a dymanic muscular sling immediately anteroinferior to the glenohumeral joint, especially when the arm was in a vulnerable position of abduction and external rotation.…”

“…They believed that the rerouted conjoined tendon should provide a dymanic muscular sling immediately anteroinferior to the glenohumeral joint, especially when the arm was in a vulnerable position of abduction and external rotation. Clinical reports on these procedures were scarce in the literature, and the results were controversial [7–9, 12, 29]. In the series of Chatterjee et al [7], 42 of 44 recurrent anterior dislocations of the shoulder treated by the modified Boytchev procedure showed excellent results, with only one recurrence that occurred after operation immediately.…”