Pdf the bristowlatarjet procedure, a historical note on a. Sven lichtenberg involves dissecting the ca ligament and pectoralis minor from the coracoid and performing a coracoid osteotomy. 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. Thus, a latarjetcoracoid process transfer is performed based on preoperative diagnostic imaging and arthroscopic evaluation of the percentage of bone loss. 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. It can also be used as a salvage procedure in revision cases. Subscapularis structural integrity and function after.
Prom as instructed restrictionsexercise progression. The allarthroscopic latarjet al procedure was introduced to manage recurrent shoulder instability. Burkhart, md the following relationships with commercial interests related to this presentation existed during the past 12 months. The congruent arc latarjet technique developed by dr. Volume 19, issue 2, supplement, march 2010, pages 212. The shoulder joint provides a wide range of movement to the upper extremity but overuse or trauma can cause instability to the joint. Open versus arthroscopic latarjet procedure for anterior. 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. Get more help on how to request a quote or surgical evaluation.
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. Despite excellent clinical results, the complication rates are reported between 15 and 30 %. 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. Pdf arthroscopic latarjet for recurrent shoulder instability.
The procedure was first described by french surgeon dr. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. It was first described by a french surgeon, michel latarjet, in 1954. As a relative new procedure, the available clinical evidence regarding the long term outcomes of arthroscopic latarjet procedure is still limited.
The modern version of the original technique prevents further episodes of dislocation in 9899% of patients and has a very low complication rate. The bony prominence at the front of the shoulder coracoid is. Latarjet procedure for shoulder instability latarjet. Longterm results of the latarjet procedure for the. Pdf modified latarjet procedure for patients with glenoid bone. The modern version of the original technique prevents further episodes of dislocation in 9899% of patients and has a. It can be performed as either an open or arthroscopic procedure. Arthroscopic latarjet procedure shoulder pain exercise. The bristowlatarjet procedure remains a good method of treatment for primary anterior shoulder instability. The glenoid bone loss set includes unique instrumentation and implants to make the open latarjet technique more consistent and repeatable.
Wed like to understand how you use our websites in order to improve them. The latarjet procedure was developed over 50 years ago by french surgeons to treat shoulder instability. 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 main objective was to report the clinical outcomes of patients undergoing a latarjet procedure after 1. There are a few modifications of the original techniques described by latarjet. Longterm results of the open latarjet procedure for recurrent. 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. Consultant for and receives royalties from arthrex, inc. However, the situation can arise when the need for a latarjet procedure becomes apparent only on initial arthroscopic inspection. The latarjet procedure at the national football league. Fig 1 for which the evaluation of imaging xrays and mri reveals that the bbl is offtrack and. The latarjet coracoid transfer procedure provides a triple blocking effect in the treatment of anterior shoulderinstability. Aspetar sports medicine journal open latarjet procedure.
Article information, pdf download for modified arthroscopic latarjet. The outcomes and surgical techniques of the latarjet procedure article pdf available in arthroscopy the journal of arthroscopic and related surgery 302. The latarjet is a very effective and robust method to prevent further shoulder dislocations. We believe that this success can be transferred using an all arthroscopic technique and gain the advantages of minimally invasive surgery.
The latarjet and iliac crest bone graft transfer icbgt procedures are competing treatment options for anterior shoulder instability with glenoid bone loss. The arthroscopic latarjet procedure is considered in the following situations. The latarjet procedure is an operation to stabilise the shoulder of an anterior dislocator when there is significant. Miniopen latarjet procedure for recurrent anterior shoulder. First, it increases the amount of bone of the shoulder socket to restore bone that had been lost or damaged. Glorion anterior instability of the shoulder longterm results of. 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. 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. The arthroscopic latarjet procedure is the same procedure but performed through keyhole incisions using very specialised instruments.
Open versus arthroscopic latarjet procedure for anterior shoulder instability. Arthroscopic remplissage and open latarjet procedure for the. Latarjet operation for shoulder reconstruction allan young. This procedure is done for recurrent shoulder instability where the instability is associated with bone loss at the front of the glenoid socket. The pdf of the article you requested follows this cover page. 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. 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.
The open latarjet procedure has shown to have excellent and reproducible results in recurrent instability. Pdf the bristowlatarjet procedure is a wellknown surgical technique designed to treat shoulder instability. 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. The bristowlatarjet procedure is considered the current gold standard for the management of anterior. The essential feature of this procedure was the transplantation of the coracoid process to the neck of the scapula through the subscapularis tendon. Thus, a latarjet coracoid process transfer is performed based on preoperative diagnostic imaging and arthroscopic evaluation of the percentage of bone loss. 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. 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. It is usually performed for anteroinferior shoulder instability.
Rehabilitation guidelines for open latarjet anterior. The bristowlatarjet procedure is a wellknown surgical technique designed to treat shoulder instability. Treatment of shoulder instability due to glenoid bone loss can be challenging. Ice and modalities to reduce pain and inflammation. Arthroscopic remplissage and open latarjet procedure for. 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. 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 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. Best implant choice for coracoid graft fixation during the latarjet.
We describe our indications and surgical technique for the. It is no means intended to be a substitute for ones clinical decision making. Sven lichtenberg involves dissecting the ca ligament and pectoralis minor from the coracoid and performing a. 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. The latarjet procedure can improve anterior stability by multiple mechanisms, not only can the bankart. Results of modified latarjet reconstruction in patients with anteroinferior instability and significant bone loss. 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. Anterior shoulder instability is common in contact athletes, particularly in american football players. Michel latarjet in 1954 also known as latarjet bristow procedure. Treatment of recurrent dislocation of the shoulder. It has the advantages of improving both the bony and soft tissue problems, with a strong fixation, allowing early active rehabilitation.
Glorion anterior instability of the shoulder longterm results of the latarjet procedure for the treatment of. Latarjet procedure brian bjerke, md postoperative protocol phase i maximum protection week 0 to 6 goals. Pdf the outcomes and surgical techniques of the latarjet. Alternative management of the capsule in the bristowlatarjet. The latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss. The bra strap incision in the open latarjet procedure journal of. Anterior shoulder instability is prevalent, most commonly affecting young, athletic patients with high functional demands.
Burkhart, md san antonio, texas disclosures stephen s. The latarjet procedure for recurrent anterior shoulder instability. Longterm results of the latarjet procedure for the treatment. Common reconstructive techniques include the latarjet procedure coracoid transfer or glenoid augmentation using autograft iliac crest. For this reason it is necessary to consent patients accordingly. Miniopen latarjet procedure for recurrent anterior. The latarjet procedure is used to treat recurrent anterior shoulder instability in patients with bony glenoid loss andor failed previous stabilisation surgery. 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. A 5cm skin incision is made, starting at the tip of the coracoid process and extending inferiorly.
On the other hand, the latarjet procedure does not repair but rather reconstructs and augments the anterior glenoid. Technical pearls for shoulder surgery tips for the. Latarjet procedure, shoulder, instability, dislocation, sports, bony glenoid loss. We use a congruent arc technique developed by joe debeer, which increases the joint surface contact area, enhancing the joint stability. 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. Contraindications and complications of the latarjet procedure. Longterm results of the latarjet procedure for the treatment of anterior instability of the shoulder. 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.
Latarjet procedure for recurrent instability in patients with recurrent anterior instability and high. Matthew provencher has described an alternative that uses fresh distal tibia allograft dta. 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. 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. To investigate the efficacy of the suturebutton latarjet procedure with at. We recognize that the internet is a global communications medium. 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 transfer of the coracoid bone block to the anterior glenoid provides stability via the triple blocking effect. Complications of the latarjet procedure request pdf. This procedure was first described in 1954 by latarjet for the treatment of recurrent dislocation of the shoulder. The latarjet procedure accomplishes two important tasks. Jun 15, 2015 the bristow latarjet procedure remains a good method of treatment for primary anterior shoulder instability.
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