The stabilizing mechanism of the latarjet procedure: A cadaveric study

Nobuyuki Yamamoto, Takayuki Muraki, Kai Nan An, John W. Sperling, Robert H. Cofield, Eiji Itoi, Gilles Walch, Scott P. Steinmann

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Background: The Latarjet procedure has been used commonly for extra-articular treatment of anterior glenohumeral joint instability. Recently, the technique also has been used as a bone-grafting procedure to repair large glenoid defects. The "sling effect" and the "bone-block effect" have been proposed as the stabilizing mechanisms of this procedure. The aim of this study was to determine the stabilizing mechanisms of this procedure. Methods: Eight fresh-frozen shoulders were prepared and tested with use of a custom testing machine instrumented with a load cell. With a 50-N axial force applied to the humerus, the humeral head was translated anteriorly. Translational force was measured at both the end-range and the mid-range arm positions, with the capsule intact, after creation of a Bankart lesion, after creation of a large glenoid defect, and after the Latarjet procedure with no load and then three different sets of loads applied to the subscapularis and conjoint tendons. Then, these two tendons were removed to observe the contribution of the sling effect to the stability. Finally, the sutures attaching the coracoacromial ligament to the capsular flap were removed in order to observe the effect of that attachment. Results: The translational force, which decreased significantly after creation of a Bankart lesion or a large glenoid defect, returned to the intact-condition level after the Latarjet procedure was performed. At the end-range arm position, the contribution of the sling effect by the subscapularis and conjoint tendons was 76% to 77% as the load changed, and the remaining 23% to 24% was contributed by the suturing of the capsular flap. At the mid-range position, the contribution of the sling effect was 51% to 62%, and the remaining 38% to 49% was contributed by the reconstruction of the glenoid. Conclusions: The main stabilizing mechanism of the Latarjet procedure was the sling effect at both the end-range and the mid-range arm positions. Clinical Relevance: The Latarjet procedure remains an effective procedure for restoring stability to an unstable glenohumeral joint, particularly when there is glenoid bone deficiency.

Original languageEnglish (US)
Pages (from-to)1390-1397
Number of pages8
JournalJournal of Bone and Joint Surgery - Series A
Volume95
Issue number15
DOIs
StatePublished - Aug 7 2013

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Tendons
Humeral Head
Shoulder Joint
Rotator Cuff
Acromioclavicular Joint
Joint Instability
Bone and Bones
Bursitis
Bone Transplantation
Sutures
Capsules
Joints
Bankart Lesions
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Yamamoto, N., Muraki, T., An, K. N., Sperling, J. W., Cofield, R. H., Itoi, E., ... Steinmann, S. P. (2013). The stabilizing mechanism of the latarjet procedure: A cadaveric study. Journal of Bone and Joint Surgery - Series A, 95(15), 1390-1397. https://doi.org/10.2106/JBJS.L.00777

The stabilizing mechanism of the latarjet procedure : A cadaveric study. / Yamamoto, Nobuyuki; Muraki, Takayuki; An, Kai Nan; Sperling, John W.; Cofield, Robert H.; Itoi, Eiji; Walch, Gilles; Steinmann, Scott P.

In: Journal of Bone and Joint Surgery - Series A, Vol. 95, No. 15, 07.08.2013, p. 1390-1397.

Research output: Contribution to journalArticle

Yamamoto, N, Muraki, T, An, KN, Sperling, JW, Cofield, RH, Itoi, E, Walch, G & Steinmann, SP 2013, 'The stabilizing mechanism of the latarjet procedure: A cadaveric study', Journal of Bone and Joint Surgery - Series A, vol. 95, no. 15, pp. 1390-1397. https://doi.org/10.2106/JBJS.L.00777
Yamamoto N, Muraki T, An KN, Sperling JW, Cofield RH, Itoi E et al. The stabilizing mechanism of the latarjet procedure: A cadaveric study. Journal of Bone and Joint Surgery - Series A. 2013 Aug 7;95(15):1390-1397. https://doi.org/10.2106/JBJS.L.00777
Yamamoto, Nobuyuki ; Muraki, Takayuki ; An, Kai Nan ; Sperling, John W. ; Cofield, Robert H. ; Itoi, Eiji ; Walch, Gilles ; Steinmann, Scott P. / The stabilizing mechanism of the latarjet procedure : A cadaveric study. In: Journal of Bone and Joint Surgery - Series A. 2013 ; Vol. 95, No. 15. pp. 1390-1397.
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AU - Cofield, Robert H.

AU - Itoi, Eiji

AU - Walch, Gilles

AU - Steinmann, Scott P.

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