First, it increases the amount of bone of the shoulder socket to restore bone that had been lost or damaged. Pdf arthroscopic latarjet for recurrent shoulder instability. Latarjet procedure for shoulder instability latarjet. We recognize that the internet is a global communications medium. Rehabilitation guidelines for open latarjet anterior. It involves using a bone graft from the shoulder blade coracoid and attaching it to the front of the shoulder joint glenoid with the help of 2 screws. Burkhart, md the following relationships with commercial interests related to this presentation existed during the past 12 months. Latarjet protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a latarjet procedure for anterior. However, the situation can arise when the need for a latarjet procedure becomes apparent only on initial arthroscopic inspection.
The essential feature of this procedure was the transplantation of the coracoid process to the neck of the scapula through the subscapularis tendon. The modern version of the original technique prevents further episodes of dislocation in 9899% of patients and has a very low complication rate. The presented surgical technique of an arthroscopic hillsachs remplissage in combination with an open latarjet procedure may be indicated in patients with recurrent posttraumatic anteroinferior shoulder instability with combined bony defects involving the glenoid and the humerus bbl with agi. Volume 19, issue 2, supplement, march 2010, pages 212. Ice and modalities to reduce pain and inflammation. Aspetar sports medicine journal open latarjet procedure. Consultant for and receives royalties from arthrex, inc. Thus, a latarjetcoracoid process transfer is performed based on preoperative diagnostic imaging and arthroscopic evaluation of the percentage of bone loss. The bristowlatarjet procedure remains a good method of treatment for primary anterior shoulder instability. Best implant choice for coracoid graft fixation during the latarjet. Latarjet operation for shoulder reconstruction allan young. Glorion anterior instability of the shoulder longterm results of.
The latarjet coracoid transfer procedure provides a triple blocking effect in the treatment of anterior shoulderinstability. As a relative new procedure, the available clinical evidence regarding the long term outcomes of arthroscopic latarjet procedure is still limited. It was first described by a french surgeon, michel latarjet, in 1954. Second, the muscles attached to the coracoid when it is relocated, create a sling to help support the shoulder in the front of the joint. We describe our indications and surgical technique for the. Arthroscopic remplissage and open latarjet procedure for the. Arthroscopic latarjet procedure shoulder pain exercise. The congruent arc latarjet technique developed by dr. Michel latarjet in 1954 also known as latarjet bristow procedure. The latarjet procedure is an established surgical treatment option for anterior shoulder instability with bone loss or other risk factors for failure following soft tissue stabilization. Our study aimed to report the outcomes of al procedures with the rowe, university of californialos angeles ucla, simple shoulder test sst scores, and range of motion rom in external rotation at a minimum followup of 2 years. It can also be used as a salvage procedure in revision cases.
Arthroscopic remplissage and open latarjet procedure for. Longterm results of the latarjet procedure for the. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a latarjet procedure for anterior stabilization. The latarjet procedure is an orthopedic procedure in the shoulder where a coracoid bone block is positioned flush with the anteriorinferior border of the glenoid often with one or more screws. The bristowlatarjet procedure is considered the current gold standard for the management of anterior. It is no means intended to be a substitute for ones clinical decision making. The arthroscopic latarjet procedure is the same procedure but performed through keyhole incisions using very specialised instruments.
The latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss. Prom as instructed restrictionsexercise progression. The increase in bone area by securing the coracoid to the glenoid and resultant soft tissue sling from tendon attachments on the coracoid leads to a stabilized glenohumeral joint. The transfer of the coracoid bone block to the anterior glenoid provides stability via the triple blocking effect.
The pdf of the article you requested follows this cover page. Pdf the bristowlatarjet procedure, a historical note on a. The open latarjet procedure has proven to be an effective procedure in the treatment of anterior shoulder instability, particularly in patients with glenoid bone loss andor an engaging hillsachs lesion. On the other hand, the latarjet procedure does not repair but rather reconstructs and augments the anterior glenoid. This procedure is done for recurrent shoulder instability where the instability is associated with bone loss at the front of the glenoid socket.
For this reason it is necessary to consent patients accordingly. Technical pearls for shoulder surgery tips for the latarjet. Get more help on how to request a quote or surgical evaluation. Technical pearls for shoulder surgery tips for the. Miniopen latarjet procedure for recurrent anterior shoulder. Methods in this bicentric prospective randomized study, 60 patients with anterior shoulder instability and glenoid bone loss were included and randomized to either an open latarjet or open.
Contraindications and complications of the latarjet procedure. It has the advantages of improving both the bony and soft tissue problems, with a strong fixation, allowing early active rehabilitation. The latarjet operation was first described by a french surgeon dr michel latarjet and has been used very successfully to reconstruct shoulders with recurrent anterior instability. This information is intended for use by customers, patients, and healthcare professionals in the united states only. The latarjet and iliac crest bone graft transfer icbgt procedures are competing treatment options for anterior shoulder instability with glenoid bone loss. Latarjet procedure brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. The bristowlatarjet experience is intended to provide to the orthopedic surgeon a means of bone fixation and to assist in.
Latarjet procedure, shoulder, instability, dislocation, sports, bony glenoid loss. Complications of the latarjet procedure request pdf. It is usually performed for anteroinferior shoulder instability. The latarjet procedure can improve anterior stability by multiple mechanisms, not only can the bankart.
This procedure is mainly performed when there is some bone loss from the front of the glenoid as a result of a bony bankart lesion or repeated dislocations wearing away the front of the glenoid. Longterm results of the latarjet procedure for the treatment of anterior instability of the shoulder. Treatment of recurrent dislocation of the shoulder. Matthew provencher has described an alternative that uses fresh distal tibia allograft dta. We believe that this success can be transferred using an all arthroscopic technique and gain the advantages of minimally invasive surgery. The bony prominence at the front of the shoulder coracoid is. Latarjetcoracoid process transfer for glenoid deficiency. However, considering the benefits of arthroscopic surgeries over open surgeries and the excellent results of the current study, arthroscopic latarjet procedure could be a preferable procedure for. The latarjet procedure for recurrent anterior shoulder instability. The glenoid bone loss set includes unique instrumentation and implants to make the open latarjet technique more consistent and repeatable. The latarjet procedure is an operation to stabilise the shoulder of an anterior dislocator when there is significant. The bra strap incision in the open latarjet procedure journal of. The latarjet procedure was developed over 50 years ago by french surgeons to treat shoulder instability.
Arthroscopic latarjet for recurrent shoulder instability. Pdf download for longterm results of the open latarjet procedure for. The latarjet procedure accomplishes two important tasks. Latarjet procedure for recurrent instability in patients with recurrent anterior instability and high. Open versus arthroscopic latarjet procedure for anterior shoulder instability. The latarjet procedure is used to treat recurrent anterior shoulder instability in patients with bony glenoid loss andor failed previous stabilisation surgery. Jun 15, 2015 the bristow latarjet procedure remains a good method of treatment for primary anterior shoulder instability. Longterm results of the latarjet procedure for the treatment. The latarjet procedure is a surgical procedure performed to treat shoulder instability by relocating a piece of bone with an attached tendon to the shoulder joint. The latarjet procedure at the national football league. The latarjet operation is a surgical procedure used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid, and was first described by a french surgeon dr.
Miniopen latarjet procedure for recurrent anterior. It has reportedly high success rates, but recent publications have reported concerns of high complication rates. The latarjet procedure is a wellknown technique to treat anterior glenohumeral instability and is recommended in certain conditions such as osseous defects, recurrences after soft tissue stabilization procedures, or for special groups of patients who are at high risk of recurrence. Pdf modified latarjet procedure for patients with glenoid bone.
The outcomes and surgical techniques of the latarjet procedure. Pdf the outcomes and surgical techniques of the latarjet. The latarjet operation, also known as the latarjetbristow procedure, is a surgical procedure used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid. Common reconstructive techniques include the latarjet procedure coracoid transfer or glenoid augmentation using autograft iliac crest. Article information, pdf download for modified arthroscopic latarjet. To investigate the efficacy of the suturebutton latarjet procedure with at. The principle of a latarjet procedure is to cut and move the coracoid bone with the conjoined tendon coracobrachialis and short head of biceps to fill in the bony defect in the glenoid to recreate the contour of the golf tee. The procedure was first described by french surgeon dr.
Results of modified latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Fig 1 for which the evaluation of imaging xrays and mri reveals that the bbl is offtrack and. Anterior shoulder instability is prevalent, most commonly affecting young, athletic patients with high functional demands. This procedure was first described in 1954 by latarjet for the treatment of recurrent dislocation of the shoulder. The latarjet procedure involves passing an osteotomised coracoid process graft with attached conjoint tendon through a horizontal splitting of the subscapularis tendon and securing the graft onto the anterior surface of the glenoid where the bony defect has occurred 1 latarjet m. Open versus arthroscopic latarjet procedure for anterior. Pdf the bristowlatarjet procedure is a wellknown surgical technique designed to treat shoulder instability.
Thus, a latarjet coracoid process transfer is performed based on preoperative diagnostic imaging and arthroscopic evaluation of the percentage of bone loss. We use a congruent arc technique developed by joe debeer, which increases the joint surface contact area, enhancing the joint stability. The bristowlatarjet procedure is a wellknown surgical technique designed to treat shoulder instability. There are a few modifications of the original techniques described by latarjet. The open latarjet procedure has shown to have excellent and reproducible results in recurrent instability. Sven lichtenberg involves dissecting the ca ligament and pectoralis minor from the coracoid and performing a coracoid osteotomy. Latarjet protocol the intent of this protocol is to provide the clinician with a guideline of the post operative rehabilitation course of a patient that has undergone a latarjet procedure for.
Feb 04, 2015 the latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss. Sven lichtenberg involves dissecting the ca ligament and pectoralis minor from the coracoid and performing a. This procedure continues to be a safe treatment option in a wide range of patients with posttraumatic anterior shoulder instability in terms of stability with good performance with regard to overall symptoms. Alternative management of the capsule in the bristowlatarjet. The main objective was to report the clinical outcomes of patients undergoing a latarjet procedure after 1.
The amount of bone loss is best determined on a 3d ct the principle of a latarjet procedure is to cut and move the coracoid bone with the conjoined tendon coracobrachialis and short head of biceps to the anteroinferior glenoid to compensate for the bony defect in the glenoid to recreate the contour of the tee. Treatment of shoulder instability due to glenoid bone loss can be challenging. The outcomes and surgical techniques of the latarjet procedure article pdf available in arthroscopy the journal of arthroscopic and related surgery 302. Glorion anterior instability of the shoulder longterm results of the latarjet procedure for the treatment of.
Longterm results of the open latarjet procedure for recurrent. The latarjet is a very effective and robust method to prevent further shoulder dislocations. It can be performed as either an open or arthroscopic procedure. Burkhart, md san antonio, texas disclosures stephen s. Request pdf complications of the latarjet procedure the latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting. The latarjet operation, also known as the latarjet bristow procedure, is a surgical procedure used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. Anterior shoulder instability is common in contact athletes, particularly in american football players. Despite excellent clinical results, the complication rates are reported between 15 and 30 %. The arthroscopic latarjet procedure is considered in the following situations.
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