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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-01-2018 | Shoulder

Latarjet procedure using subscapularis split approach offers better rotational endurance than partial tenotomy for anterior shoulder instability

Authors: Ali Ersen, Fevzi Birisik, Hakan Ozben, Ata Can Atalar, Turker Sahinkaya, Aksel Seyahi, Mehmet Demirhan

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2018

Abstract

Purpose

Latarjet, which is a coracoid bone block procedure, is an effective treatment for anterior shoulder instability with glenoid bone loss. During this reconstructive procedure the subscapularis may be tenotomized or be split to expose the glenoid neck. The aim of this study was to assess the effect of subscapularis management on functional outcomes and internal and external rotation durability and strength. Hypothesis is that the subscapularis split approach will result in better functional results and superior internal rotation strength and endurance.

Methods

The study included 48 patients [median age 30 (range 16–69); 42 males, 6 females], who underwent a modified Latarjet procedure for anterior shoulder instability. There were 20 patients in the subscapularis tenotomy group and 28 patients in the subscapularis split group. The groups were compared isokinetically using a computerized dynamometer for internal and external rotation durability and strength. At the latest follow-up, the patients were evaluated with the American Shoulder and Elbow Surgeons (ASES) and ROWE scores for functional outcomes.

Results

At a median follow-up period of 25 (range 12–73) months after the Latarjet procedure, the internal rotation durability was significantly higher in the split group (p = 0.045). However, a statistically significant difference could not be found for internal and external rotational strengths (n.s.). There was also no significant difference between the final ASES and ROWE scores (n.s.).

Conclusion

Although both approaches offer promising results, the subscapularis split approach appears to provide better internal rotation durability compared to subscapularis tenotomy. Therefore, the subscapularis split approach may be more preferable for the management of the subscapularis muscle during Latarjet procedure.

Level of evidence

Retrospective cohort study, Level III.

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Title: Latarjet procedure using subscapularis split approach offers better rotational endurance than partial tenotomy for anterior shoulder instability
Authors: Ali Ersen
Fevzi Birisik
Hakan Ozben
Ata Can Atalar
Turker Sahinkaya
Aksel Seyahi
Mehmet Demirhan
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-017-4480-3

At a glance: The STEP trials

Springer Medicine

Latarjet procedure using subscapularis split approach offers better rotational endurance than partial tenotomy for anterior shoulder instability

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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