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Arthroscopic guided Latarjet

Published in N°278 - November 2018
Article viewed 63 times

Arthroscopic guided Latarjet

By Pascal Boileau, Patrick Gendre, Dave saliken, J.-François Gonzalez, Christophe trojani, C.-Edouard Thélu, Jérome Vogel, Nicolas BonneVialle in category TECHNIQUE

Coracoid transfer to treat anterior shoulder instability, first proposed by French surgeon Michel Latarjet in 1954 and popularized by Gilles Walch, is increasingly used in cases of glenoid deficiency, hyperlaxity, and revision anterior stabilization. The technique has 2 main advantages...

Rationale of the Latarjet Procedure

Coracoid transfer to treat anterior shoulder instability, first proposed by French surgeon Michel Latarjet in 1954 and popularized by Gilles Walch, is increasingly used in cases of glenoid deficiency, hyperlaxity, and revision anterior stabilization. The technique has 2 main advantages: (1) it allows reconstruction of the glenoid bone loss by expanding the surface area of the glenoid for continued contact with the humeral head (static glenohumeral stabilization), and (2) it reinforces the weak and stretched inferior glenohumeral ligament by transferring the conjoint tendon closer to the joint and lowering the inferior part of the subscapularis (dynamic sling or seat-belt stabilization). Recent biomechanical studies have suggested that the sling effect is most responsible for the stabilizing effect of the Latarjet. Together with the reattachment of the labrum and capsule (i.e., Bankart repair), it allows “triple locking” of the shoulder (Didier Patte). The 2B3 (Latarjet+ Bankart) (Fig. 1) procedure yields good results with a low rate of recurrent instability, a high rate of return to sport to preinjury levels, and a high rate of patient satisfaction.

Figure 1:
Left - Inferior weak point .
Right - Triple "Blocking" (2B3)

 

In the traditional...

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