Early-term effectiveness of Latarjet procedure by coracoid osteotomy with preserving coracoacromial ligament for recurrent anterior shoulder dislocation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHONG Hehe , CHEN Fang , JIN Ying , LIU Xiuqi , XIONG Huazhang ,  WU Shuhong

Department of Orthopedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563000, P. R. China;

Corresponding?author：

WU Shuhong, Email: 15329112966@163.com

Keywords：

Latarjet procedure; anterior shoulder dislocation; recurrent dislocation; coracoacromial ligament; coracoid

DOI：

10.7507/1002-1892.202403108

Video：

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Objective To evaluate the early-term effectiveness of Latarjet procedure with double EndoButtons fixation for recurrent anterior shoulder dislocation by coracoid osteotomy with preserving coracoacromial ligament. Methods Between January 2021 and June 2023, 19 patients with recurrent anterior shoulder dislocations were treated by arthroscopic Latarjet procedure with double EndoButtons fixation, all of which underwent coracoid osteotomy with preserving the coracoacromial ligament. There were 11 males and 8 females, with an average age of 23.3 years (range, 17-32 years). Shoulder dislocations ranged from 3 to 11 times, with an average of 6.4 times. The disease duration ranged from 3 to 35 months, with an average of 12.9 months. All apprehension tests were positive. Imaging examination showed that the defect width of the ipsilateral glenoid bone was 13%-26%, with an average of 19.8%. After operation, the shoulder range of motion was examined, including flexion lift, lateral external rotation, extension 90° external rotation, and internal rotation. Shoulder joint function was evaluated by Walch-Duplay score, American Association for Shoulder and Elbow Surgery (ASES) score, and Rowe score. Imaging examinations were taken to observe the position and shaping of coracoid. Results All incisions healed by first intention and no nerve or vessel injury occurred. All patients were followed up 9-24 months (mean, 14.5 months). There was no recurrence of shoulder dislocation and the apprehension tests were negative during follow-up. There was no significant difference in the shoulder range of motion (flexion lift, lateral external rotation, extension 90° external rotation, and internal rotation) between preoperation and at last follow-up (P>0.05). The Walch-Duplay score, ASES score, and Rowe score significantly improved when compared with those before operation (P<0.05). Postoperative imaging showed that coracoid graft was at the same level with the glenoid in all cases; the center of coracoid graft was located between 3 to 5 o’clock. During follow-up, there was no glenohumeral joint degeneration, the acromiaohumeral distance was not reduced when compared with preoperation, and the coracoid bone gradually formed concentric circles with the humeral head. Conclusion The Latarjet procedure with double EndoButtons fixation can effectively treat recurrent anterior shoulder dislocation by coracoid osteotomy with preserving coracoacromial ligament, and the early-term effectiveness is satisfactory.

Citation： ZHONG Hehe, CHEN Fang, JIN Ying, LIU Xiuqi, XIONG Huazhang, WU Shuhong. Early-term effectiveness of Latarjet procedure by coracoid osteotomy with preserving coracoacromial ligament for recurrent anterior shoulder dislocation. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(6): 655-659. doi: 10.7507/1002-1892.202403108 Copy

1.	Hurley ET, Jamal MS, Ali ZS, et al. Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies an 10-year follow-up. J Shoulder Elbow Surg, 2019, 28(2): 33-39.
2.	Tanaka M, Hanai H, Kotani Y, et al. Open Bristow versus open Latarjet for anterior shoulder instability in Rugby players: Radiological and clinical outcomes. Orthop J Sports Med, 2022, 10(5): 23259671221095094. doi: 10.1177/23259671221095094.
3.	Longo UG, Loppini M, Rizzello G, et al. Latarjet, Bristow, and Eden-Hybinette procedures for anterior shoulder dislocation: systematic review and quantitative aynthesis of the literature. Arthroscopy, 2014, 30(9): 1184-1211.
4.	李海鵬, 辛培源, 黃俊翔, 等. 肩關節不穩Latarjet術后螺釘斷裂的思考. 中國矯形外科雜志, 2023, 31(2): 187-188, 190.
5.	Hendy BA, Padegimas EM, Kane L, et al. Early postoperative complications after Latarjet procedure: a single-institution experience over 10 years. J Shoulder Elbow Surg, 2021, 30(6): 300-308.
6.	覃其煌, 姜春巖. Latarjet手術治療復發性肩關節前脫位術后移植骨塊骨吸收的研究進展. 中國修復重建外科雜志, 2023, 37(5): 526-532.
7.	Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg, 2016, 25(1): 78-89.
8.	Gaujac N, Bouché PA, Belas M, et al. The arthroscopic Latarjet procedure with a posterior guided system and suture-button fixation enables more precise bone block positioning in the axial plane versus anterior screws fixation. Knee Surg Sports Traumatol Arthrosc, 2024, 32(3): 750-762.
9.	梁達強, 蒯聲政, 李瑛, 等. Latarjet手術治療肩關節前向脫位中螺釘固定與紐扣固定的生物力學對比分析. 中國修復重建外科雜志, 2020, 34(5): 602-607.
10.	Xu J, Liu H, Lu W, et al. Modified arthroscopic Latarjet procedure: Suture-button fixation achieves excellent remodeling at 3-year follow-up. Am J Sports Med, 2020, 48(1): 39-47.
11.	仲鶴鶴, 金瑛, 向寬, 等. 改良關節鏡下雙袢法Latarjet術治療復發性肩關節前脫位的近期療效. 中國修復重建外科雜志, 2022, 36(9): 1072-1077.
12.	劉修齊, 陳方, 仲鶴鶴, 等. 改良彈性固定Latarjet術治療伴明顯關節盂骨缺損復發性肩關節前脫位的短期隨訪. 中國組織工程研究, 2023, 27(29): 4684-4689.
13.	Su WR, Budoff JE, Luo ZP. The effect of coracoacromial ligament excision and acromioplasty on superior and anterosuperior glenohumeral stability. Arthroscopy, 2009, 25(1): 13-18.
14.	Degen RM, Giles JW, Boons HW, et al. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: the Latarjet procedure versus allograft reconstruction. Int J Shoulder Surg, 2013, 7(1): 7-13.
15.	潘昭勛, 閔小軍, 孫超, 等. 喙肩弓對肩關節前上方穩定性作用的生物力學研究. 醫用生物力學, 2017, 32(4): 384-387.
16.	Aurich M, Hofmann GO, Gras F. Reconstruction of the coracoacromial ligament during a modified Latarjet procedure: a case series. BMC Musculoskelet Disord, 2015, 16(1): 1-9.
17.	鐘名金, 陸偉, 柳海峰, 等. 改良關節鏡雙袢法Latarjet術治療嚴重骨缺損的復發性肩關節前脫位. 中華肩肘外科電子雜志, 2018, 6(1): 38-46.
18.	柳海峰, 陸偉, 許鑒, 等. 改良線袢法Latarjet技術治療肩關節復發性脫位的中期療效及移植骨塊塑形模式分析. 中國內鏡雜志, 2019, 25(6): 1-8.
19.	Dalmas Y, Thélu CE, Laumonerie P, et al. Arthroscopic double-button Latarjet osteolysis and remodeling at 1-year follow-up. J shoulder Elbow Surg, 2022, 31(12): 603-612.
20.	朱玥潤, 魏暢, 毛慶花, 等. 喙肩韌帶的解剖學分型及臨床意義. 解剖學研究, 2022, 44(5): 488-491.
21.	Demir M, Güneri B. Geometric morphology of the coracoacromial ligament: a cadaveric study. Biomed Res Int, 2019, 2019: 3024769. doi: 10.1155/2019/3024769.
22.	任中楷, 汪建, 于騰波. 喙突解剖學測量及相關性研究. 青島大學學報(醫學版), 2020, 56(5): 513-515.

1. Hurley ET, Jamal MS, Ali ZS, et al. Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies an 10-year follow-up. J Shoulder Elbow Surg, 2019, 28(2): 33-39.
2. Tanaka M, Hanai H, Kotani Y, et al. Open Bristow versus open Latarjet for anterior shoulder instability in Rugby players: Radiological and clinical outcomes. Orthop J Sports Med, 2022, 10(5): 23259671221095094. doi: 10.1177/23259671221095094.
3. Longo UG, Loppini M, Rizzello G, et al. Latarjet, Bristow, and Eden-Hybinette procedures for anterior shoulder dislocation: systematic review and quantitative aynthesis of the literature. Arthroscopy, 2014, 30(9): 1184-1211.
4. 李海鵬, 辛培源, 黃俊翔, 等. 肩關節不穩Latarjet術后螺釘斷裂的思考. 中國矯形外科雜志, 2023, 31(2): 187-188, 190.
5. Hendy BA, Padegimas EM, Kane L, et al. Early postoperative complications after Latarjet procedure: a single-institution experience over 10 years. J Shoulder Elbow Surg, 2021, 30(6): 300-308.
6. 覃其煌, 姜春巖. Latarjet手術治療復發性肩關節前脫位術后移植骨塊骨吸收的研究進展. 中國修復重建外科雜志, 2023, 37(5): 526-532.
7. Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg, 2016, 25(1): 78-89.
8. Gaujac N, Bouché PA, Belas M, et al. The arthroscopic Latarjet procedure with a posterior guided system and suture-button fixation enables more precise bone block positioning in the axial plane versus anterior screws fixation. Knee Surg Sports Traumatol Arthrosc, 2024, 32(3): 750-762.
9. 梁達強, 蒯聲政, 李瑛, 等. Latarjet手術治療肩關節前向脫位中螺釘固定與紐扣固定的生物力學對比分析. 中國修復重建外科雜志, 2020, 34(5): 602-607.
10. Xu J, Liu H, Lu W, et al. Modified arthroscopic Latarjet procedure: Suture-button fixation achieves excellent remodeling at 3-year follow-up. Am J Sports Med, 2020, 48(1): 39-47.
11. 仲鶴鶴, 金瑛, 向寬, 等. 改良關節鏡下雙袢法Latarjet術治療復發性肩關節前脫位的近期療效. 中國修復重建外科雜志, 2022, 36(9): 1072-1077.
12. 劉修齊, 陳方, 仲鶴鶴, 等. 改良彈性固定Latarjet術治療伴明顯關節盂骨缺損復發性肩關節前脫位的短期隨訪. 中國組織工程研究, 2023, 27(29): 4684-4689.
13. Su WR, Budoff JE, Luo ZP. The effect of coracoacromial ligament excision and acromioplasty on superior and anterosuperior glenohumeral stability. Arthroscopy, 2009, 25(1): 13-18.
14. Degen RM, Giles JW, Boons HW, et al. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: the Latarjet procedure versus allograft reconstruction. Int J Shoulder Surg, 2013, 7(1): 7-13.
15. 潘昭勛, 閔小軍, 孫超, 等. 喙肩弓對肩關節前上方穩定性作用的生物力學研究. 醫用生物力學, 2017, 32(4): 384-387.
16. Aurich M, Hofmann GO, Gras F. Reconstruction of the coracoacromial ligament during a modified Latarjet procedure: a case series. BMC Musculoskelet Disord, 2015, 16(1): 1-9.
17. 鐘名金, 陸偉, 柳海峰, 等. 改良關節鏡雙袢法Latarjet術治療嚴重骨缺損的復發性肩關節前脫位. 中華肩肘外科電子雜志, 2018, 6(1): 38-46.
18. 柳海峰, 陸偉, 許鑒, 等. 改良線袢法Latarjet技術治療肩關節復發性脫位的中期療效及移植骨塊塑形模式分析. 中國內鏡雜志, 2019, 25(6): 1-8.
19. Dalmas Y, Thélu CE, Laumonerie P, et al. Arthroscopic double-button Latarjet osteolysis and remodeling at 1-year follow-up. J shoulder Elbow Surg, 2022, 31(12): 603-612.
20. 朱玥潤, 魏暢, 毛慶花, 等. 喙肩韌帶的解剖學分型及臨床意義. 解剖學研究, 2022, 44(5): 488-491.
21. Demir M, Güneri B. Geometric morphology of the coracoacromial ligament: a cadaveric study. Biomed Res Int, 2019, 2019: 3024769. doi: 10.1155/2019/3024769.
22. 任中楷, 汪建, 于騰波. 喙突解剖學測量及相關性研究. 青島大學學報(醫學版), 2020, 56(5): 513-515.

Chinese Journal of Reparative and Reconstructive Surgery

Early-term effectiveness of Latarjet procedure by coracoid osteotomy with preserving coracoacromial ligament for recurrent anterior shoulder dislocation

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