Both the open and the arthroscopic methods produce excellent clinical results, with a low rate of recurrent instability. The procedure was performed entirely arthroscopically in 41 of 47 patients 88%. Latarjet technique for treatment of anterior shoulder instability with. Arthrex latarjetcoracoid process transfer for glenoid. The pdf of the article you requested follows this cover page.
Latarjet operation for shoulder reconstruction allan young. There are a few modifications of the original techniques described by latarjet. Sling for 3 weeks athletes can wean off sooner under guidance of club therapist teach axillary hygiene. Open versus arthroscopic latarjet procedure for the. The open approach begins after the diagnostic arthroscopy. Common reconstructive techniques include the latarjet procedure coracoid transfer or glenoid augmentation using autograft iliac crest. Aspetar sports medicine journal open latarjet procedure. The latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The latarjet procedure was performed on the basis of a patients medical history, clinical examination results, and radiologic findings. The arthroscopic latarjet procedure for the treatment of anterior. Arthroscopic remplissage and open latarjet procedure for the. The latarjet procedure is a wellknown, safe and reliable technique to treat primary or recurrent anterior dislocations or subluxations, with or without hyperlaxity, with or without glenoid bone loss. Sven lichtenberg involves dissecting the ca ligament and pectoralis minor from the coracoid and performing a coracoid osteotomy.
Changes in the neurovascular anatomy of the shoulder after. Pdf miniopen latarjet procedure for recurrent anterior. The original description of this procedure by latarjet involved sectioning of the subscapularis. Michel latarjet in 1954 also known as latarjet bristow procedure. Patients were followed up for a minimum of 2 years for complications range 2460 months. I can use my left hand almost as good as my right but i cant cut my food, wash my hair, etc. Latarjet procedure surgery shoulder hubby works from home as it is impossible to do things by myself.
Ice and modalities to reduce pain and inflammation. Aug 26, 2019 common reconstructive techniques include the latarjet procedure coracoid transfer or glenoid augmentation using autograft iliac crest. The senior author started his practice with the open latarjet procedure and progressed to an arthroscopic approach over time. The latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss. Glorion anterior instability of the shoulder longterm results of the latarjet procedure. Open latarjet a reliable, successful method to prevent. Get more help on how to request a quote or surgical evaluation. Postoperative protocols this rehabilitation protocol has been developed for the patient following an open bankart latarjet coracoid transfer surgical procedure. 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.
It has reportedly high success rates, but recent publications have reported concerns of high complication rates. This is an enhanced pdf from the journal of bone and joint surgery j bone joint surg am. Surgical technique arthroscopic bankart repair interscalene block, awake patient beachchair. Open latarjet for anterior stabilization clinical practice guideline background ohio states latarjet anterior shoulder stabilization rehabilitation guideline is to be utilized following open anterior shoulder stabilization procedures. Aspetar sports medicine journal open latarjet procedure for. A number of variations have been described for the latarjet procedure. Contraindications and complications of the latarjet procedure. The shoulder joint provides a wide range of movement to the upper extremity but overuse or trauma can cause instability to the joint. Miniopen latarjet procedure for recurrent anterior.
Open latarjet anterior shoulder stabilization the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee. In this technical note, the surgical technique of an arthroscopic hillsachs remplissage in combination with an open latarjet procedure is presented. The latarjet procedure employs rerouting of the osteotomised coracoid process with its attached conjoined tendon through. Both open and arthroscopic latarjet procedures can be used to effectively treat shoulder instability with similarly low rates of complications, recurrent instability and need for revision surgery. First invented in 1954 by french surgeon dr michel latarjet, the advanced versions help achieve above 98% success rate. Latarjet surgery for preventing shoulder dislocation. A 5cm skin incision is made, starting at the tip of the coracoid process and extending inferiorly. Prom as instructed restrictionsexercise progression. Complications of the latarjet procedure springerlink. Use a radiofrequency device through the s portal to further open the tendon. 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. In total, 73 of 81 patients 90% participated in regular sporting activity.
Thus, a latarjet coracoid process transfer is performed based on preoperative diagnostic imaging and arthroscopic evaluation of the percentage of bone loss. Pdf the effect of open bristowlatarjet procedure for. Open versus arthroscopic latarjet procedures for the treatment of. Patients were followed up for a minimum of 2 years for. Glenoid bone loss may dictate the success of procedures to restore anterior shoulder instability. Further research and clinical experience will dictate which. 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 stabilization. Changes in the neurovascular anatomy of the shoulder after an. Pdf miniopen latarjet procedure for recurrent anterior shoulder. The modern version of the original technique prevents further episodes of dislocation in 9899% of patients and has a very low complication rate. The latarjet procedure is the most popular and highly effective. During the procedure the anterior coracoid is harvested and attached.
The bristow latarjet procedure remains a good method of treatment for primary anterior shoulder instability. Even the zealots do an open procedure in athletes with bony defects of the humeral head or glenoid. 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. Despite excellent clinical results, the complication rates are reported between 15 and 30 %. Most studies that have investigated this procedure include patients with an average age of 27 years.
The latarjet procedure has been advocated as an option for the treatment of. There is no difference in postoperative arthritis following coracoid transfer and open anterior soft tissue procedures 17. The latarjet procedure is an accepted treatment option for anteroinferior shoulder instability. Open latarjet anterior shoulder stabilization the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on. The modern version of the original technique prevents further episodes of dislocation in 9899% of patients and has a. These injuries will require a procedure called a latarjet anterior shoulder stabilization. The latarjet is a very successful procedure at restoring stability to the shoulder joint. The glenoid bone loss set includes unique instrumentation and implants to make the open latarjet technique more consistent and repeatable. The primary indications for the latarjet procedure include recurrent anterior shoulder subluxations or dislocations with or without hyperlaxity and 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. These primarily relate to the surgical approach, position and fixation of the coracoid and the management of the capsulolabral tissues. Latarjet procedure gilbert, chandler, mesa az ospi. More than 200 different operations have been described for the treatment of recurrent anterior dislocation of shoulder. Arthroscopic guided latarjet and bankart surgical technique.
As newer surgical techniques have improved, the latarjet is now seldom used for a standard dislocation repair. This procedure is appropriate for traumatic and atraumatic episodes alike. It is performed under general anaesthesia and nerve block as a day case, or with overnight stay. Mini open latarjet technique 3 1 2 5 4 6 prepare the glenoid neck with a burr make sure, the bone graft is positioned properly on the glenoid rim remove the tcdc and apply the second screw over the guide wire the plate ensures a proper contact area between coracoid and glenoid.
Glorion anterior instability of the shoulder longterm results of the latarjet procedure for the treatment of. The purpose of this paper is to explain our surgical procedure titled mini open latarjet procedure. About 2cm of the bone is cut and moved to the front part of the shoulder in order to make a new shoulder socket. The transfer of the coracoid bone block to the anterior glenoid provides stability via the triple blocking effect. Overall, 81 open latarjet procedures were included in our. Pdf anterior shoulder instability is a common problem. Open stabilisation latarjet procedure this operation is performed to stabilise a shoulder where bone damage has occurred after traumatic shoulder dislocations. We describe our indications and surgical technique for the. The purpose of this paper is to explain our surgical procedure titled miniopen. Longterm results of the latarjet procedure for the. 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. The procedure was first described by french surgeon dr.
We present a practical guide to the open latarjet procedure, addressing many of technical challenges to aid the reader in future decisionmaking regarding indications, approach, exposure, surgical technique, and rehabilitation. Patients treated with arthroscopic latarjet procedures had significantly lower initial postoperative pain, however pain scores became. This analogy is used because the articular surface of the round humeral head upper most part of the arm is approximately four times greater than that of the relatively. One of the principal methods of open treatment for this problem is the latarjet procedure, as described in his article in 1954.
Clinical and radiographic outcomes of the open latarjet. Open stabilisation latarjet procedure windsor upper limb. Overall, 81 open latarjet procedures were included in our analysis with 96. It is no means intended to be a substitute for ones clinical decision making.
The bony prominence at the front of the shoulder coracoid is. The purpose of this paper is to explain our surgical procedure titled mini open. The procedure is performed on a 27 year old male, who has a four year history. The principle of a latarjet procedure is to cut and move the coracoid bone. Intraoperative complications such as graft malpositioning, neurovascular injury, and graft. The principle of a latarjet procedure is to cut and move the coracoid. The latarjet procedure is an operation to stabilise the shoulder of an anterior dislocator when. The arthroscopic and open latarjet procedures are both known to successfully treat shoulder instability with high success rates. Immediately postoperatively, exercises must be modified so as not to place unnecessary stress on the anterior joint capsule of the shoulder. The latarjet procedure has been advocated as an option for the treatment of anteroinferior. Technical guide and tips on the allarthroscopic latarjet. Several papers found significantly better standardized outcome scores for either the open or arthroscopic procedure but these findings were not consistent across papers.
Contact athletessummary consider an open technique in contact athletes. The congruent arc latarjet technique developed by dr. An incision is made over the front of your shoulder. Laith jazrawi presents his approach to anterior shoulder instability using the latarjet procedure coracoid process transfer. It can also be used as a salvage procedure in revision cases. This procedure is done for recurrent shoulder instability where the instability is associated with bone loss at the front of the glenoid socket. In an attempt to make the arthroscopic latarjet procedure safer and to reduce complications associated with the traditional screw. In the latarjet procedure, an incision is made over the front part of your shoulder and the coracoid bone is exposed. Both the open and the arthroscopic methods produce.
Rehabilitation guidelines for open latarjet anterior. The purpose of this study was to describe the rate and type of complications occurring within 90 days following the latarjet procedure for anterior glenohumeral instability. Miniopen latarjet procedure shoulder instability treatment. 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. Once the dressing is removed on the first or second day, ice is applied for 20minute periods. The latarjet procedure is a surgical procedure performed to treat shoulder instability by relocating a piece of. The allarthroscopic latarjet is a reliable but difficult technique.
Congruent arc latarjet the glenoid bone loss set includes unique instrumentation and implants to make the open latarjet technique more consistent and repeatable. In these cases, the combination of a hillsachs remplissage and the latarjet procedure can be effective in preventing persistent instability. Technical guide and tips on the allarthroscopic latarjet procedure. Charles eggert, md postoperative protocol phase i maximum protection week 0 to 6 goals. The effect of open bristow latarjet procedure for anterior shoulder instability. Sep 11, 2017 the latarjet procedure is a wellknown, safe and reliable technique to treat primary or recurrent anterior dislocations or subluxations, with or without hyperlaxity, with or without glenoid bone loss. Dec 05, 2011 anterior shoulder instability is a common problem. The natural evolution of this procedure was to develop an allarthroscopic technique that captures all of the advantages of the open procedure while using a minimally invasive technique. History of surgical intervention of anterior shoulder instability david m.
Rehabilitation guidelines for open latarjet anterior shoulder. Latarjet anterior stabilization of the shoulder protocol latissimus dorsi tendon transfer protocol open shoulder anterior stabilization posterior and posterior inferior capsular shift protocol rehabilitation after rotator cuff repair. Despite the promising outcomes of the latarjet, the complication rate remains high. Coracoid transfer, particularly the latarjet procedure, has become the treatment. Hovelius reported 15year results following the latarjet procedure and found 14% of patients had moderate or severe osteoarthritis oa, commenting that no other longterm study of the bankart demonstrated less oa 18.
Miniopen latarjet procedure for recurrent anterior shoulder. Latarjet procedure for recurrent anterior shoulder instability. Contraindications and complications the authors 2017 of the. 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. The latarjet procedure is used to treat recurrent anterior shoulder instability in patients with bony glenoid loss andor failed previous stabilisation surgery. The resulting bone loss leads to anterior instability that cannot be corrected with soft tissuelabral repair alone. In fact, historically, this surgery was used as a standard treatment for people with shoulder dislocations. History of surgical intervention of anterior shoulder. The latarjet procedure is one of the most used surgical methods to treat recurrent anterior instability in the shoulder.
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