a cadaveric studytranslational force was measured at both the end-range and the mid-range arm...

The Stabilizing Mechanism of the Latarjet ProcedureA Cadaveric Study

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

Investigation performed at the Mayo Clinic, Rochester, Minnesota

Background: The Latarjet procedure has been used commonly for extra-articular treatment of anterior glenohumeral jointinstability. 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 aimof 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 instrumentedwith a load cell. With a 50-N axial force applied to the humerus, the humeral head was translated anteriorly. Translationalforce was measured at both the end-range and the mid-range arm positions, with the capsule intact, after creation of aBankart lesion, after creation of a large glenoid defect, and after the Latarjet procedure with no load and then threedifferent sets of loads applied to the subscapularis and conjoint tendons. Then, these two tendons were removed toobserve the contribution of the sling effect to the stability. Finally, the sutures attaching the coracoacromial ligament to thecapsular 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 glenoiddefect, 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, thecontribution of the sling effect was 51% to 62%, and the remaining 38% to 49% was contributed by the reconstructionof the glenoid.

Conclusions: The main stabilizing mechanism of the Latarjet procedure was the sling effect at both the end-range andthe mid-range arm positions.

Clinical Relevance: The Latarjet procedure remains an effective procedure for restoring stability to an unstableglenohumeral joint, particularly when there is glenoid bone deficiency.

Surgical stabilizing procedures for treating anterior instabilityof the glenohumeral joint can be divided into two groups:intra-articular and extra-articular. Intra-articular stabilizing

procedures include the Bankart repair, and extra-articular tech-niques include the Latarjet procedure. The coracoid transferprocedures lost popularity for a period of time after a high rate ofpostoperative osteoarthritis was reported1-3. However, recent re-ports4-6 have shown that postoperative arthritis can be avoidedby appropriate positioning of a coracoid bone graft. Cora-coid transfer procedures for the treatment of shoulders with a

large glenoid defect have therefore gained popularity onceagain7-10.

Although a Bankart lesion itself is not repaired in theoriginal Latarjet procedure or in most of the modified Latarjetprocedures, excellent clinical outcomes have been reported4,11-15.Clinicians believe that the stabilizing mechanism of this proce-dure is the ‘‘sling effect’’ of the subscapularis4,16,17 or con-joint tendon7,11 or the ‘‘bone-block effect.’’16 To date, fewbiomechanical studies have demonstrated the stabilizing mech-anism of Latarjet procedures18. The aim of the present study was

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party insupport of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six monthsprior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is writtenin this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential toinfluence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with theonline version of the article.

1390

COPYRIGHT � 2013 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED

J Bone Joint Surg Am. 2013;95:1390-7 d http://dx.doi.org/10.2106/JBJS.L.00777

to determine the stabilizing mechanism of this extra-articularstabilizing procedure for shoulders with anterior instability andwith a large glenoid defect. Our hypothesis was that the mainstabilizing mechanism of this procedure was the sling effect at theend-range arm position and reconstruction of the glenoid con-cavity at the mid-range position.

Materials and MethodsSpecimen Preparation

Eight fresh-frozen shoulders from seven men and one woman with amean age at the time of death of seventy-five years (range, fifty-two to

ninety-three years) were used. The shoulders were screened for rotator cufftears and radiographic evidence of moderate to severe glenohumeral osteoar-thritis. The subcutaneous soft tissues were removed except for the rotator cuffmuscles. The body of the scapula was removed, and the glenoid was potted in acontainer that was attached to a custom mechanical testing device (AvalonTechnologies, Rochester, Minnesota). In order to orient the glenoid articularsurface accurately parallel to the floor, two Kirschner wires were passed throughthe glenohumeral joint before testing was performed.

Testing Apparatus (Fig. 1)The testing device consisted of a six-component load cell (model 45E15A-E24ES-A; JR3, Woodland, California) mounted on a motorized x-y table. The xaxis and y axis were defined as the anterior-posterior and superior-inferiordirections, respectively, and the z axis (i.e., vertical) was defined as the medial-lateral direction. The vertical movement of the humeral head was measured witha linear potentiometer (TR-50; Novotechnik, Stuttgart, Germany) attached to thesliding device. According to the manufacturer, the linearity of this potentiometerwas 0.15%. The horizontal movement of the humeral head was measured with asecond linear potentiometer (LCPL Open Frame Linear Potentiometer; StateElectronics, Oceanside, California) attached to the x-y table. The linearity of this

second potentiometer was 0.5%. A 50-N axial force was applied to the humeralhead with use of a pneumatic cylinder. This specific value of 50 N was determinedon the basis of previous studies

19-21. Lazarus et al.

20reported that, with active

in vivo abduction, the force normal to the glenoid was always >50 N. Inaddition, it was demonstrated that, with an applied compressive load of 50 N,dislocation did not cause gross damage to the tissue.

Testing ProtocolFirst, the neutral position was determined by measuring the humeral head positionwhen it was seated most medially in the glenoid

19,22. This reference neutral position

was used for the subsequent displacement-controlled study23

. Because the value ofthe translational force was affected by the humeral head position, it was importantthat the humeral head started from the neutral position. The humeral head wastranslated anteriorly for 10 mm at a rate of 2 mm/sec. All specimens were testedwith use of this 10-mm-displacement protocol

19,24. However, the force analysis was

based on a normalized displacement that was proportional to the glenoid length(superior-inferior dimension). The 10-mm displacement distance was used for thelongest glenoid (37 mm); the displacement distances for all other glenoids weredownscaled accordingly. The translational force occurring at a normalized dis-placement of 8.5 ± 0.72 mm (range, 7.6 to 10 mm) was used.

Arm PositionsBecause the main stabilizing mechanisms could differ between the end-rangeand mid-range positions of the glenohumeral joint

21,25, we used both for

testing. We used 60� of abduction relative to the scapula (90� of abductionrelative to the trunk) in the scapular plane and maximum external rotationto simulate the end-range position, and we used 60� of abduction in the scapularplane and neutral rotation to simulate the mid-range position. These positionswere determined on the basis of previous studies

19,26-28. The screw inserted per-

pendicular to the humeral shaft was used as a reference point for neutral rotationof the humerus. The maximum external rotation was established by applyinga constant torque to the humeral head.

Fig. 1

Schematic drawing of the custom mechanical testing device, consisting of a six-component load cell mounted on a motorized x-y table. Muscle traction

during testing was applied with use of pulleys and weights. The weight ‘‘A’’ was applied to the conjoint tendon and the weight ‘‘B,’’ to the subscapularis

muscle.

1391

TH E J O U R N A L O F B O N E & JO I N T SU R G E RY d J B J S . O R G

VO LU M E 95-A d NU M B E R 15 d AU G U S T 7, 2013TH E STA B I L I Z I N G ME C H A N I S M O F T H E

LATA R J E T PR O C E D U R E

Test ConditionsThe translational force was measured under eight conditions at the end-rangeand mid-range arm positions. The eight conditions were (1) with the capsuleintact, (2) with a simulated Bankart lesion, (3) with a large glenoid defect (Fig.2), (4) after the Latarjet procedure without load, (5) after the Latarjet procedurewith load (described later) applied to the subscapularis and conjoint tendons,(6) after removal of these two tendons, (7) after removal of the sutures con-necting the coracoacromial ligament to the capsular flap, and (8) after release ofthe attachments of the anterior aspect of the capsule to the glenoid labrum. ABankart lesion was simulated by elevating the capsulolabral insertion from theglenoid from the two o’clock to the eight o’clock position in the right shoulder.In addition, the continuity of the labrum was transected at three o’clock withuse of a knife

19,24. A large glenoid defect was created in order to determine

the contribution of the coracoid process graft to the stability of the joint. This6-mm defect of the glenoid width was biomechanically demonstrated to bethe critical size of the glenoid defect

24. Osteotomy was performed parallel to

the longitudinal axis of the glenoid, centered at the three o’clock position. Thesubscapularis and conjoint tendons were released from loading (but not cut) sothat the contribution of the sling effect to stability could be observed. The suturesattaching the coracoacromial ligament were removed in order to see the effect ofthis attachment on stability. The anterior aspect of the capsule (from the twelveo’clock to the six o’clock position) was then released so that the effect of recon-struction of the glenoid could be discerned.

Three sets of loads were applied with use of pulleys and weights todetermine the relationship between the loading of muscles and the transla-tional force; 10 N and 2.5 N, 20 N and 5 N, and 30 N and 7.5 N were applied tothe subscapularis and conjoint tendons, respectively. The actual force of thesubscapularis muscle with the arm positioned in abduction and neutral ro-tation has been calculated to be 58 N

29. However, only one-third (20 N) of this

force was chosen as the base load applied to the subscapularis tendon becauseof concern that the muscles might be damaged if the full 58-N load wereapplied. We determined the ratio of those loads on the basis of the relative

Fig. 2

Photograph of a large glenoid defect, which was a 6-mm defect of the glenoid

width (26% of the glenoid surface) created at the three o’clock position.

Fig. 3

Graph showing the stability at the end-range position. The translational force, which significantly decreased after creation of a Bankart lesion, significantly

increased after the Latarjet procedure was performed. The force significantly decreased after removal of the subscapularis (SSC) and conjoint tendons. The force

further decreased after removal of the sutures to the capsular flap. The translational forces are expressed as the mean and the standard deviation. *P < 0.05

comparedwith the intact condition.**P<0.05comparedwith theBankart lesion.yP<0.05comparedwith theLatarjet procedure.yyP<0.05comparedwith the

condition after removal of the subscapularis and conjoint tendons. Remove SSC&conj = after removal of the two tendon loads. Remove CAL = after removal of the

sutures of the coracoacromial ligament. Cut ant capsule = after release of the attachments of the anterior aspect of the capsule to the glenoid labrum.

1392




physiological cross-sectional areas of each muscle30

. The ratio between thesubscapularis muscle and the short head of the biceps and coracobrachialismuscles was 4:1.

Surgical ProcedureThe surgical procedure was performed as described by Walch and Boileau

4. The

subscapularis muscle/tendon was divided at the superior two-thirds junction.The distal 2 cm of the coracoid process was osteotomized with use of a smallangulated saw, and a portion of the coracoacromial ligament was retained. Thebone block was positioned flush to the anterior-inferior glenoid margin. It wastransferred to the glenoid neck after a small capsulotomy (1.5 cm), removal ofthe labrum, and decortication of the glenoid. If necessary, the graft was contouredwith a power burr to fit the shape of the glenoid. Two AO 4.5-mm malleolarscrews were driven into the posterior cortex. The coracoacromial ligamentremnant on the coracoid process was sutured to the anterior capsular flap. Finally,the horizontal split in the subscapularis was sutured. A Bankart repair wasnot performed.

Data AnalysisOne-way repeated-measures analysis of variance was used to compare theforces and humeral displacements among the different capsule and glenoidconditions. When a significant effect was observed, the Dunnett multiple-comparisons procedure was used to determine which individual values differedfrom one another. This procedure was also used to compare the forces amongthree different load conditions. Statistical analysis was performed with use ofStatView software (SAS Institute, Cary, North Carolina), with significance setat p < 0.05. With eight cadaveric shoulders in each group, there was an 80%power to detect an effect size of >1.2, with the effect size defined as the meanof the change divided by the standard deviation of the change.

Source of FundingThe equipment and devices used for this study were purchased with fundingprovided by the Mayo Foundation and the Uehara Memorial Foundation.

ResultsEnd-Range Position (Figs. 3 and 4)

The translational force decreased significantly after creationof the Bankart lesion (p < 0.001) and after creation of

the large glenoid defect (p < 0.001). The force increased sig-nificantly after the Latarjet procedure without loading (p <0.0026). There was a significant difference between the forcesmeasured after the Latarjet procedure with no loading and allof those measured after the Latarjet procedures with loading(p < 0.0001), although the force remained unchanged after

Fig. 4

Graph showing the lateral humeral displacement at the end-range position.

The lateral humeral displacement decreased significantly in shoulders with

a large glenoid defect compared with the displacement in the intact

condition. The displacement increased significantly after the Latarjet

procedure. The displacement values are expressed as the mean and

the standard deviation. *P < 0.001 compared with the intact condition.

**P < 0.001 compared with a large glenoid defect. Remove SSC&conj =

after removal of the two tendon (subscapularis and conjoint) loads. Re-

move CAL = after removal of the sutures of the coracoacromial ligament.

Cut ant capsule = after release of the attachments of the anterior aspect

of the capsule to the glenoid labrum.

Fig. 5

Graph showing the stability at the mid-range position. The

translational force, which significantly decreased after

creation of a Bankart lesion or a large glenoid defect,

significantly increased after the Latarjet procedure. The

force significantly decreased after removal of the

subscapularis (SSC) and conjoint tendons. The transla-

tional forces are expressed as the mean and the stan-

dard deviation. *P < 0.05 compared with the intact

condition. **P < 0.05 compared with a glenoid defect.

yP < 0.05 compared with the Latarjet procedure. Remove

SSC&conj = after removal of the two tendon loads.Remove

CAL = after removal of the sutures of the coracoacromial

ligament. Cut ant capsule = after release of the attach-

ments of the anterior aspect of the capsule to the glenoid

labrum.

1393




the increases in load. After removal of the two tendons, the forcedecreased significantly (p < 0.001). The difference between themagnitude of force under the ‘‘Bankart lesion-created’’ conditionand that under the ‘‘Latarjet procedure-performed’’ conditioncorresponded to the stability provided by the Latarjet procedure.With this latter stability defined as 100%, the force reduction afterremoval of the two tendons was 76% ± 3% (p = 0.0029), 76% ±3% (p = 0.0123), and 77% ± 2% (p = 0.0008), respectively, underthe three sets of loads. The force further decreased after the su-tures were removed from the capsular flap (p = 0.005). The forcedid not decrease significantly more after the anterior aspect of thecapsule was released. Thus, because the mean contribution of thesling effect to the stability was 76% to 77%, the remaining 23% to24% contribution to stability came from suturing the capsularflap.

The lateral humeral displacement decreased signifi-cantly in shoulders with a large glenoid defect (p < 0.001).The displacement of the shoulders with a large glenoid defectincreased significantly after the Latarjet procedures wereperformed (p < 0.001). There were no significant differencesamong the subsequent conditions after the Latarjet proce-dure was performed.

Mid-Range Position (Figs. 5 and 6)The translational force decreased significantly after creationof either a Bankart lesion (p < 0.001) or a large glenoid defect(p < 0.001). After the Latarjet procedure without loading, theforce increased significantly (p < 0.001). The force increasedsignificantly (p = 0.004) with increases in the load. After removalof the two tendon loads, the force decreased significantly (p =0.005). However, the force did not significantly decrease againafter removal of the sutures to the capsular flap or after release ofthe anterior aspect of the capsule. The difference between themagnitude of force under the ‘‘glenoid defect-created’’ conditionand that under the ‘‘Latarjet procedure-performed’’ conditioncorresponded to the change in stability. Again, with this latterstability defined as 100%, the force reduction after removal ofthe two tendons was 51% ± 3% (p = 0.010), 57% ± 3% (p =0.001), and 62% ± 2% (p < 0.001), respectively, under the threesets of loads. The force did not decrease further after removal ofthe sutures to the capsular flap or after release of the anterioraspect of the capsule. Thus, because the mean contribution ofthe sling effect to stability was 51% to 62%, the glenoid re-construction, by process of elimination, contributed the re-maining 38% to 49%.

The lateral humeral displacement decreased significantlyboth in the shoulders with a Bankart lesion and in those with alarge glenoid defect (p < 0.001 and p < 0.001, respectively). Thedisplacement increased significantly after performance of theLatarjet procedures (p < 0.001). There were no significant dif-ferences among the subsequent conditions after performance ofthe Latarjet procedure.

Discussion

There have been few reports biomechanically clarifying thestabilizing mechanism of the Latarjet procedure18. The

present data show that the translational force was restored tothe intact-condition level after the Latarjet procedure wasperformed. The shoulder became stable after the procedureeven if there was a Bankart lesion with a large glenoid defect.It was demonstrated that the main stabilizing mechanism ofthe Latarjet procedure was the sling effect produced by thesubscapularis and conjoint tendons. If the subscapularis orconjoint tendon is dysfunctional for some reason, one cannotexpect the sling effect to be produced by these two tendons.Although a Bankart repair was not performed, our resultsshowed that suturing of the coracoacromial ligament createda capsular-repair effect, indicating that an effect equivalent tothat of a Bankart repair can be expected from suturing of thecoracoacromial ligament. Another clinical implication of thisstudy is that the Latarjet procedure provides more stabilitythan is present in the normal shoulder at the end-range of mo-tion, providing a rationale for performing the Latarjet procedurein patients at high risk for recurrence, such as athletes whoparticipate in collision sports.

At the end-range arm position, 76% to 77% of the sta-bility was contributed by the sling effect. The remaining 23% to24% was contributed by the suturing of the coracoacromialligament. In the mid-range position, the contribution of the

Fig. 6

Graph showing the lateral humeral displacement at the mid-range position.

The lateral humeral displacement decreased significantly both in shoul-

ders with a Bankart lesion and in those with a large glenoid defect com-

pared with the displacement in the intact condition. The displacement

increased significantly after the Latarjet procedure. The displacement

values are expressed as the mean and the standard deviation. *P < 0.001

compared with the intact condition. **P < 0.001 compared with a large

glenoid defect. Remove SSC&conj = after removal of the two tendon

(subscapularis and conjoint) loads. Remove CAL = after removal of the

sutures of the coracoacromial ligament. Cut ant capsule = after release

of the attachments of the anterior aspect of the capsule to the glenoid

labrum.

1394




sling effect was 51% to 62%. Reconstruction of the glenoidconcavity contributed the remaining 38% to 49%. Patte et al.17

proposed the concept of ‘‘triple locking,’’ which includes repair ofthe capsule (capsular locking), preservation of the lower one-third of the subscapularis (tendinomuscular locking), andextension of the osseous glenoid concavity (osseous locking).Interestingly, although the observations reported by Patte et al.came from clinical experience, they are consistent with ourlaboratory results, which include the capsular-repair effect fromsuturing of the coracoacromial ligament, the sling effect from thesubscapularis and conjoint tendons, and the bone-graft effectfrom the transfer of the coracoid process. Although the presentstudy simulated a shoulder with a glenoid defect, the results of anunpublished preliminary study confirmed that a shoulderwithout a glenoid defect became stable after performance of theLatarjet procedure.

The main stabilizing mechanism of the Latarjet pro-cedure was the sling effect produced by the subscapularis andconjoint tendons. The split subscapularis tendon provided musclestability because the intersection of the transferred conjoint ten-don added tension to the inferior portion of the subscapularis(Fig. 7). At the end-range position, stability remained unchangedregardless of the increase of the load. In contrast, stability in-creased with load at the mid-range position. It has been dem-onstrated that, even if the muscles strongly contract, they do notcontribute greatly to the stability at the end range because theanterior capsular complex is the main stabilizer in this po-sition25,31-33. Also, it has been reported by various authors thatdynamic stability depends on the muscle contraction force inthe mid-range20,21,27. This finding explains why the sling effectworks most effectively in the mid-range position, at whichthe force of muscle contraction is related to the stability of thejoint.

There was a significant difference between the force fol-lowing the Latarjet procedure without loading and that followingthe procedures with loading. This difference was due to the

tension of the intersection of the transferred conjoint tendonwith the subscapularis, which was increased when the loadwas applied to these two tendons. Because many test condi-tions needed to be examined, the experiment was conductedin two phases. Our first study34 showed that the sling effect wasprovided by both the subscapularis and the conjoint tendonsacting together (rather than by either one separately).

After creation of a large glenoid defect, the force de-creased at the mid-range position because of a loss of con-cavity of the glenoid20,21. The data also showed that the forcereturned to the normal level after the transfer of the coracoidprocess. The effect of the transplant was not due to the bone-block effect (i.e., extension of the glenoid rim and blockage ofthe humeral head)16,35 but rather to a glenoidplasty effect (i.e.,reconstruction of the glenoid concavity, positioning the coracoidprocess flush to the glenoid margin) as reported by Walch andBoileau4. Because the position of the coracoid transplant differsbetween the Latarjet and Bristow procedures, the position of thetransferred conjoint tendon also differs. However, we think thatthe main stabilizing mechanism of the Bristow procedure isthe sling effect, similar to what we reported for the Latarjetprocedure, although there may be a slight difference in termsof the anatomical structures contributing to the stability of thejoint. One should always think about a possible humeral headdefect when considering a glenoid defect because glenoiddefects are associated with a high incidence of Hill-Sachslesions. According to our previous biomechanical study36, ifthere is an osseous defect of the glenoid, then the risk of theengagement between the humeral head and the glenoid in-creases. Therefore, when one considers the critical size of aHill-Sachs lesion, one should also think about the size of theglenoid deficiency.

The current study had several limitations. First, thesling effect was demonstrated experimentally under a rela-tively small amount of load, which may be different from thein vivo condition. However, it was inadvisable to apply the

Fig. 7

Schematic illustration of the sling effect at the end-range position. The sling effect was provided by the subscapularis (P) and conjoint (w) tendons. The

transferred coracoid process was fixed with two screws (*). The split subscapularis tendon provided muscle stability, working as a barrier because the

intersection of the transferred conjoint tendon added tension to the inferior portion of the subscapularis.

1395




same load to the cadaveric shoulders as is applied to shoul-ders in the living body because of a high likelihood of caus-ing muscle damage to the cadaveric shoulders. Because the invivo muscle force of the subscapularis is large (on the orderof 58 N), the sling effect may well contribute >62% duringactivities of daily living. Second, the weights that were appliedto the subscapularis and conjoint tendons may differ from thecorresponding loads present in vivo. Therefore, the measuredsling effect may differ from that in living patients. Third, thespecimens were tested with a 10-mm-displacement protocol.The humeral head normally would translate >10 mm duringshoulder dislocation. Our experimental condition is thereforedifferent from the actual condition in patients with anteriorinstability. However, if the humeral head were to be experimen-tally translated until dislocation, the soft tissues surrounding theshoulder joint would be at high risk of damage, precluding com-pletion of the subsequent testing sequences.

In conclusion, under these experimental conditions,the main stabilizing mechanism of the Latarjet procedure wasthe sling effect produced by the subscapularis and conjointtendons, at both the end-range and mid-range arm positions.The remaining stability arose from suturing of the coracoacromialligament to the capsular flap at the end-range position, andfrom glenoid cavity reconstruction at the mid-range posi-tion. It was demonstrated that the Latarjet procedure pro-vided a superior stabilizing mechanism for shoulders with

anterior shoulder instability in the presence of a glenoiddefect. n

Nobuyuki Yamamoto, MD, PhDTakayuki Muraki, PhDKai-Nan An, PhDJohn W. Sperling, MDRobert H. Cofield, MDScott P. Steinmann, MDBiomechanics Laboratory,Division of Orthopedic Research (N.Y., T.M., and K.-N.A.),and Department of Orthopedic Surgery(J.W.S., R.H.C., and S.P.S.),Mayo Clinic College of Medicine,200 First Street SW, Rochester, MN 55905.E-mail address for S.P. Steinmann: [email protected]

Eiji Itoi, MD, PhDDepartment of Orthopaedic Surgery,Tohoku University School of Medicine,Sendai 980-8574, Japan

Gilles Walch, MDDepartment of Orthopaedic Surgery,Centre Orthopedique Santy,24 Avenue P Santy,Lyon 69008, France

References

1. Young DC, Rockwood CA Jr. Complications of a failed Bristow procedure and theirmanagement. J Bone Joint Surg Am. 1991 Aug;73(7):969-81.2. Zuckerman JD, Matsen FA 3rd. Complications about the glenohumeral joint re-lated to the use of screws and staples. J Bone Joint Surg Am. 1984 Feb;66(2):175-80.3. Rowe CR, Zarins B, Ciullo JV. Recurrent anterior dislocation of the shoulder aftersurgical repair. Apparent causes of failure and treatment. J Bone Joint Surg Am.1984 Feb;66(2):159-68.4. Walch G, Boileau P. Latarjet-Bristow procedure for recurrent anterior instability.Tech Shoulder Elbow Surg. 2000;1(4):256-61.5. Edwards TB, Boulahia A, Kempf JF, Boileau P, Nemoz C, Walch G. The influence ofrotator cuff disease on the results of shoulder arthroplasty for primary osteoarthritis:results of a multicenter study. J Bone Joint Surg Am. 2002 Dec;84(12):2240-8.6. Walch G. Chronic anterior glenohumeral instability. J Bone Joint Surg Br. 1996Jul;78(4):670-7.7. Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP. Resultsof modified Latarjet reconstruction in patients with anteroinferior instability andsignificant bone loss. Arthroscopy. 2007 Oct;23(10):1033-41.8. Lafosse L, Lejeune E, Bouchard A, Kakuda C, Gobezie R, Kochhar T. Thearthroscopic Latarjet procedure for the treatment of anterior shoulder instability.Arthroscopy. 2007 Nov;23(11):e1-5. Epub 2007 Oct 03.9. Chen AL, Hunt SA, Hawkins RJ, Zuckerman JD. Management of bone loss as-sociated with recurrent anterior glenohumeral instability. Am J Sports Med. 2005Jun;33(6):912-25.10. Arrigoni P, Huberty D, Brady PC, Weber IC, Burkhart SS. The value of arthroscopybefore an open modified latarjet reconstruction. Arthroscopy. 2008 May;24(5):514-9. Epub 2008 Feb 01.11. Allain J, Goutallier D, Glorion C. Long-term results of the Latarjet procedure forthe treatment of anterior instability of the shoulder. J Bone Joint Surg Am. 1998Jun;80(6):841-52.12. Hovelius L, Sandstrom B, Saebo M. One hundred eighteen Bristow-Latarjetrepairs for recurrent anterior dislocation of the shoulder prospectively followed forfifteen years: study II-the evolution of dislocation arthropathy. J Shoulder Elbow Surg.2006 May-Jun;15(3):279-89.13. Spoor AB, de Waal Malefijt J. Long-term results and arthropathy following themodified Bristow-Latarjet procedure. Int Orthop. 2005 Oct;29(5):265-7. Epub 2005Jun 14.

14. Picard F, Saragaglia D, Montbarbon E, Tourne Y, Thony F, Charbel A. [Anatomo-clinical consequences of the vertical sectioning of the subscapular muscle inLatarjet intervention]..Rev Chir Orthop Repar Appar Mot. 1998 May;84(3):217-23.French.15. Hovelius L, Korner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berg E.The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects ofthe Bristow-Latarjet procedure. J Bone Joint Surg Am. 1983 Sep;65(7):926-34.16. Weaver JK, Derkash RS. Don’t forget the Bristow-Latarjet procedure. Clin OrthopRelat Res. 1994 Nov;(308):102-10.17. Patte D, Bernageau J, Bancel P. The anteroinferior vulnerable point of theglenoid rim. In: Bateman JE, Welsh RP, editors. Surgery of the shoulder. New York:Dekker; 1985. p 94-9.18. Wellmann M, de Ferrari H, Smith T, Petersen W, Siebert CH, Agneskirchner JD,Hurschler C. Biomechanical investigation of the stabilization principle of the Latarjetprocedure. Arch Orthop Trauma Surg. 2012 Mar;132(3):377-86. Epub 2011 Nov 16.19. Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect onanteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J BoneJoint Surg Am. 2000 Jan;82(1):35-46.20. Lazarus MD, Sidles JA, Harryman DT 2nd, Matsen FA 3rd. Effect of achondral-labral defect on glenoid concavity and glenohumeral stability. A cadavericmodel. J Bone Joint Surg Am. 1996 Jan;78(1):94-102.21. Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin OrthopRelat Res. 1993 Jun;(291):20-8.22. Tammachote N, Sperling JW, Berglund LJ, Steinmann SP, Cofield RH, An KN.The effect of glenoid component size on the stability of total shoulder arthroplasty.J Shoulder Elbow Surg. 2007 May-Jun;16(3)(Suppl):S102-6. Epub 2006 Dec 13.23. Speer KP, Deng X, Borrero S, Torzilli PA, Altchek DA, Warren RF. Biomechanicalevaluation of a simulated Bankart lesion. J Bone Joint Surg Am. 1994Dec;76(12):1819-26.24. Yamamoto N, Muraki T, Sperling JW, Steinmann SP, Cofield RH, Itoi E, An KN.Stabilizing mechanism in bone-grafting of a large glenoid defect. J Bone Joint SurgAm. 2010 Sep 1;92(11):2059-66.25. Turkel SJ, Panio MW, Marshall JL, Girgis FG. Stabilizing mechanisms preventinganterior dislocation of the glenohumeral joint. J Bone Joint Surg Am. 1981Oct;63(8):1208-17.26. Mologne TS, Zhao K, Hongo M, Romeo AA, An KN, Provencher MT. The additionof rotator interval closure after arthroscopic repair of either anterior or posterior

1396




shoulder instability: effect on glenohumeral translation and range of motion. AmJ Sports Med. 2008 Jun;36(6):1123-31. Epub 2008 Mar 04.27. Lee SB, Kim KJ, O’Driscoll SW, Morrey BF, An KN. Dynamic glenohumeralstability provided by the rotator cuff muscles in the mid-range and end-rangeof motion. A study in cadavera. J Bone Joint Surg Am. 2000 Jun;82(6):849-57.28. Yamamoto N, Itoi E, Tuoheti Y, Seki N, Abe H, Minagawa H, Shimada Y, Okada K.Effect of rotator interval closure on glenohumeral stability and motion: a cadavericstudy. J Shoulder Elbow Surg. 2006 Nov-Dec;15(6):750-8. Epub 2006 Aug 07.29. Kronberg M, Nemeth G, Brostrom LA. Muscle activity and coordination in the normalshoulder. An electromyographic study. Clin Orthop Relat Res. 1990 Aug;(257):76-85.30. Bassett RW, Browne AO, Morrey BF, An KN. Glenohumeral muscle force andmoment mechanics in a position of shoulder instability. J Biomech.1990;23(5):405-15.31. Jerosch J, Moersler M, Castro WH. [The function of passive stabilizers of theglenohumeral joint—a biomechanical study]. [German.]. Z Orthop Ihre Grenzgeb.1990 Mar-Apr;128(2):206-12.

32. O’Brien SJ, Schwartz RS, Warren RF, Torzilli PA. Capsular restraints to anterior-posterior motion of the abducted shoulder: a biomechanical study. J Shoulder ElbowSurg. 1995 Jul-Aug;4(4):298-308.33. Urayama M, Itoi E, Hatakeyama Y, Pradhan RL, Sato K. Function of the 3 por-tions of the inferior glenohumeral ligament: a cadaveric study. J Shoulder ElbowSurg. 2001 Nov-Dec;10(6):589-94.34. Yamamoto N, Muraki T, An K, Sperling J, Cofield R, Itoi E. What is the stabi-lizing mechanism of the Latarjet procedure? Presented as a poster exhibit at theAmerican Academy of Orthopaedic Surgeons Annual Meeting; 2009 Feb 25-28;Las Vegas, NV.35. Collins HR, Wilde AH. Shoulder instability in athletics. Orthop Clin North Am.1973 Jul;4(3):759-74.36. Yamamoto N, Itoi E, Abe H, Minagawa H, Seki N, Shimada Y, Okada K. Contactbetween the glenoid and the humeral head in abduction, external rotation, andhorizontal extension: a new concept of glenoid track. J Shoulder Elbow Surg. 2007Sep-Oct;16(5):649-56. Epub 2007 Jul 23.

1397




a cadaveric studytranslational force was measured at both the end-range and the mid-range arm...

Documents