Arthroscopic Latarjet Procedure Using FiberTape Cerclage With a Simplified Technique for Suture Passage and Coracoid Fixation
Ontology highlight
ABSTRACT:
SUBMITTER: Jos S
PROVIDER: S-EPMC9353334 | biostudies-literature | 2022 Jun
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundThe rates of implant-related complications are significant following the Latarjet procedure using metal screws in patients with recurrent shoulder dislocation and bone loss. The purpose of this study is to evaluate the short-term outcome following the arthroscopic Latarjet procedure using cerclage FiberTape (Arthrex, Naples, FL, USA) combined with remplissage and capsulolabral repair. It was hypothesized that performing the procedure with cerclage FiberTape would provide sturdy fixation, comparable to the conventional method of using metal screws, while averting hardware-related complications attributed to the latter in published literature.MethodsA prospective study was performed in a single institution between 2020 and 2022, with all surgeries performed by a single fellowship-trained shoulder surgeon who has ample experience in performing arthroscopic screw Latarjet procedures. Patient demographics, number of dislocations before surgery, arm dominance, ligamentous laxity, type of sporting activity, Instability Severity Index Score, and percentage of bone loss on the glenoid and humeral sides were recorded. The patients were followed up with visual analog scale, American Shoulder and Elbow Surgeons score, Rowe score, and Walch-Duplay score preoperatively and postoperatively. The coracoid graft position, healing, and remodeling were assessed with computed tomography scans at 3 months postoperatively. Minimum clinical follow-up was for a period of one year.ResultsOverall, 10 patients (all males, average age 28 ± 8.8 years) were operated on with an arthroscopic Latarjet procedure using cerclage FiberTape. The minimum follow-up period was 12 months, and the mean follow-up was 13.2 months. The median and individual visual analog scores during arm motion, American Shoulder and Elbow Surgeons scores, Rowe scores, and Walch-Duplay scores improved in the follow-up period. Computed tomography scans at 3 months showed flushed graft position in 5 patients, medial graft position in two patients, and three patients showed graft nonunion with migration. Out of 10 patients, seven had good graft union in follow-up scans. None of the patients required revision surgery. All three patients with graft nonunion were kept under follow-up beyond the study period for recurrence of instability.ConclusionOur study demonstrated that arthroscopic Latarjet using cerclage FiberTape fixation combined with remplissage and capsulolabral repair resulted in high rate of graft loosening and migration (30%). Nonetheless, patients in whom the coracoid graft had united, as well as those in whom it had not, all had good to excellent functional and clinical outcomes, no complications, and did not require any revision surgery.
| S-EPMC11401552 | biostudies-literature
Project description:The Bristow-Latarjet procedure has been one of the most recognized procedures for the treatment of recurrent shoulder dislocation with anterior glenoid bone loss, revision surgery after failed Bankart repair, contact and collision sport injuries, and patients with a high risk of recurrence. Open and arthroscopic approaches have recently shown similar outcomes by several authors. However, complications related to metal implants, despite being low, are still a matter of concern. We describe an all-arthroscopic Latarjet technique with a metal-free fixation method using 2 ultra-high-strength sutures, creating a cerclage construct through 2.4mm glenoid and coracoid tunnels with a final capsulolabral complex reconstruction.
| S-EPMC7917201 | biostudies-literature
Project description:The Latarjet procedure for treating anterior glenohumeral instability includes transfer of the coracoid and biceps tendon to the anterior glenoid. A modified method for the arthroscopic procedure was developed to facilitate the procedure and minimize the risk of injury to the brachial plexus. The detached coracoid was exteriorized through the anteroinferior portal for drilling and shaping. A Coracoid Drill Guide (Arthrex, Naples, FL) was used to help cut the coracoid to the desired size and make 2 drill holes in the coracoid for fixation to the glenoid. The Coracoid Transfer Instrument (Acierart, Masku, Finland) was designed to facilitate coracoid transfer and serve as a pin guide for fixation. Ten patients with severe anterior glenohumeral instability were treated with this technique. They had only mild to moderate postoperative pain. There were no postoperative infections or recurrent dislocations. The safety of this operation was similar to that of other operations on the coracoid process in the proximity of the brachial plexus. The modified arthroscopic Latarjet procedure may be applied successfully to the treatment of anterior glenohumeral instability, with good patient satisfaction and functional outcome.
| S-EPMC3882674 | biostudies-literature
Project description:Bristow-Latarjet procedure has been widely regarded as a reliable and satisfactory operation for recurrent anterior glenohumeral instability, especially for patients with significant glenoid bone loss or high sports demand. Once failed, however, the subsequent revision surgery could be challenging. Eden-Hybinette procedure is the most common operation for revision of failed Bristow-Latarjet. It can perfectly restore the bone defect of the failed Bristow-Latarjet by harvesting a proper size of iliac bone block. Furthermore, several studies have shown the advantages of using suture button fixation in the revision surgery for failed Bristow-Latarjet procedure. However, the potential inferior biomechanical strength of suture button fixation is still a concern. This Technical Note introduced an arthroscopic "double-inlay" Eden-Hybinette procedure with modified suture button fixation for the revision of failed Bristow-Latarjet. With its "quadruple" reinforcement effect, this procedure can achieve an excellent biomechanical strength of fixation.
| S-EPMC8719054 | biostudies-literature
Project description:The Latarjet technique is a widely used technique for anterior shoulder instability with glenoid bone defects, irreparable capsuloligamentous lesion, or in patients at greater risk of recurrence. The use of this technique has been reported to obtain satisfactory clinical and biomechanical results. Although other methods exist, the coracoid process is typically fixed with 2 metal screws. Complications related to metal fixation are very frequently reported. In an attempt to avoid these complications, we developed this arthroscopically assisted metal-free Latarjet technique in which we fix a coracoid graft using four cerclage tapes to achieve a strong, stable fixation, thus mimicking a plate.
| S-EPMC7528757 | biostudies-literature
Project description:The Latarjet procedure is a method for treating complicated glenohumeral joint dislocation that is often associated with a bone defect in the anterior glenoid. The Latarjet procedure addresses both soft-tissue and bone deficiencies by creating a biceps tendon sling and through bone reconstruction of the anterior glenoid defect. The arthroscopic Latarjet procedure provides good visual control in the structures and eliminates the need for an arthrotomy. We present an arthroscopy-assisted Latarjet technique where the coracoid is temporarily exteriorized to facilitate shaping and preparation for subsequent fixation to the glenoid. Coracoid debridement, anterior glenoid preparation, and the subscapular split are conducted arthroscopically. Cutting the coracoid process is also conducted under arthroscopic control, and the coracoid is exposed through the anteroinferior portal. Once the coracoid is openly shaped and the drill-holes are made, the coracoid is resituated and fixed to the glenoid edge in arthroscopic visual control. The purpose of this technique is to combine favorable elements of the open and arthroscopic procedures. Additionally, the instrumentation is simple, which makes the operation safe and practical to perform.
| S-EPMC8556665 | biostudies-literature
Project description:The Latarjet procedure is a method used for the treatment of shoulder instability in the presence of bone loss. A decade after the first description of the fully arthroscopic Latarjet procedure, modifications to the technique were reported to decrease the risk of complications and improve the position of the bone block. A recent trend toward the use of buttons to fix the coracoid has been reported. The technique described here is an arthroscopic Latarjet procedure that uses 2 pairs of round buttons as an alternative to screw fixation or the use of a single button, and the technique aims to combine the original procedure with safe and stable fixation.
| S-EPMC7372521 | biostudies-literature
Project description:Shoulder instability is a commonly seen pathology. The Latarjet procedure was first described in 1954 to address recurrent instability or patients with glenoid bone loss. Since its introduction, the procedure has been widely adopted and modified, including being performed all-arthroscopically. Various arthroscopic techniques have been described, but we present a technique performed in the lateral decubitus position that takes advantage of a pneumatic arm holder. After arthroscopic diagnosis, multiple accessory portals are established and used to accomplish the technique. Next, the coracoid is prepared and cut using a cannulated drill guide, followed by arthroscopic glenoid preparation using a cannulated drill system to ensure appropriate position of the coracoid. The subscapularis split is performed arthroscopically, and finally the coracoid is fixed with use of the EndoButton device.
| S-EPMC8626768 | biostudies-literature
Project description:The Latarjet procedure is used for the treatment of anterior glenohumeral instability in the presence of bone loss. One decade after a fully arthroscopic Latarjet procedure was described, this technique has been modified to reduce the risk of complications and improve the fixation method. We aimed to simplify the components of this surgical procedure.
| S-EPMC8556670 | biostudies-literature
Project description:Despite multiple modifications, the Latarjet is still the most popular procedure for recurrent anterior shoulder instability with glenoid bone loss. Partial or subtotal resorption of the graft is common, potentially leading to hardware prominence and risk of anterior soft-tissue impingement. To minimize the technical difficulties and morbidity associated with metallic implants, a coracoid and conjoint tendon transfer with a mini-open approach using Cerclage tape suture is described, as an alternative for the Latarjet procedure typically performed with metal screws and plates.
| S-EPMC10149785 | biostudies-literature