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.	李海鹏, 辛培源, 黄俊翔, 等. 肩关节不稳Latarjet术后螺钉断裂的思考. 中国矫形外科杂志, 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, 姜春岩. Latarjet手术治疗复发性肩关节前脱位术后移植骨块骨吸收的研究进展. 中国修复重建外科杂志, 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.	梁达强, 蒯声政, 李瑛, 等. Latarjet手术治疗肩关节前向脱位中螺钉固定与纽扣固定的生物力学对比分析. 中国修复重建外科杂志, 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.	仲鹤鹤, 金瑛, 向宽, 等. 改良关节镜下双袢法Latarjet术治疗复发性肩关节前脱位的近期疗效. 中国修复重建外科杂志, 2022, 36(9): 1072-1077.
12.	刘修齐, 陈方, 仲鹤鹤, 等. 改良弹性固定Latarjet术治疗伴明显关节盂骨缺损复发性肩关节前脱位的短期随访. 中国组织工程研究, 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.	潘昭勋, 闵小军, 孙超, 等. 喙肩弓对肩关节前上方稳定性作用的生物力学研究. 医用生物力学, 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.	钟名金, 陆伟, 柳海峰, 等. 改良关节镜双袢法Latarjet术治疗严重骨缺损的复发性肩关节前脱位. 中华肩肘外科电子杂志, 2018, 6(1): 38-46.
18.	柳海峰, 陆伟, 许鉴, 等. 改良线袢法Latarjet技术治疗肩关节复发性脱位的中期疗效及移植骨块塑形模式分析. 中国内镜杂志, 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.	朱玥润, 魏畅, 毛庆花, 等. 喙肩韧带的解剖学分型及临床意义. 解剖学研究, 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, 于腾波. 喙突解剖学测量及相关性研究. 青岛大学学报(医学版), 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. 李海鹏, 辛培源, 黄俊翔, 等. 肩关节不稳Latarjet术后螺钉断裂的思考. 中国矫形外科杂志, 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, 姜春岩. Latarjet手术治疗复发性肩关节前脱位术后移植骨块骨吸收的研究进展. 中国修复重建外科杂志, 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. 梁达强, 蒯声政, 李瑛, 等. Latarjet手术治疗肩关节前向脱位中螺钉固定与纽扣固定的生物力学对比分析. 中国修复重建外科杂志, 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. 仲鹤鹤, 金瑛, 向宽, 等. 改良关节镜下双袢法Latarjet术治疗复发性肩关节前脱位的近期疗效. 中国修复重建外科杂志, 2022, 36(9): 1072-1077.
12. 刘修齐, 陈方, 仲鹤鹤, 等. 改良弹性固定Latarjet术治疗伴明显关节盂骨缺损复发性肩关节前脱位的短期随访. 中国组织工程研究, 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. 潘昭勋, 闵小军, 孙超, 等. 喙肩弓对肩关节前上方稳定性作用的生物力学研究. 医用生物力学, 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. 钟名金, 陆伟, 柳海峰, 等. 改良关节镜双袢法Latarjet术治疗严重骨缺损的复发性肩关节前脱位. 中华肩肘外科电子杂志, 2018, 6(1): 38-46.
18. 柳海峰, 陆伟, 许鉴, 等. 改良线袢法Latarjet技术治疗肩关节复发性脱位的中期疗效及移植骨块塑形模式分析. 中国内镜杂志, 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. 朱玥润, 魏畅, 毛庆花, 等. 喙肩韧带的解剖学分型及临床意义. 解剖学研究, 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, 于腾波. 喙突解剖学测量及相关性研究. 青岛大学学报(医学版), 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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