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The Latarjet coracoid process transfer procedure: alterations in the neurovascular structures
Michael T Freehill1, Umasuthan Srikumaran, Kristin R Archer
1Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Journal of Shoulder and Elbow Surgery
|September 6, 2012
Summary
The Latarjet procedure alters the positions of the musculocutaneous and axillary nerves, increasing their vulnerability during revision surgery. The axillary artery
Area of Science:
- Orthopedic surgery
- Anatomy
- Surgical outcomes
Background:
- The Latarjet coracoid process transfer is a standard treatment for glenoid deficiency and recurrent anterior shoulder instability.
- Concerns exist regarding potential neurovascular changes following this procedure.
Purpose of the Study:
- To investigate the anatomical alterations of neurovascular structures after performing the Latarjet procedure in a cadaveric model.
Main Methods:
- Utilized 8 fresh-frozen cadaveric shoulders for analysis.
- Measured distances from the glenoid rim to nerves and artery in various arm positions pre- and post-Latarjet procedure.
- Employed paired Student t tests to compare pre- and post-operative measurements.
Main Results:
- Observed significant superior-to-inferior positional changes in the musculocutaneous nerve.
- Noted laxity and consistent overlap between the musculocutaneous and axillary nerves.
- Found no significant change in the axillary artery's location.
Conclusions:
- The Latarjet procedure causes significant and consistent changes in the relative positions of the musculocutaneous and axillary nerves.
- These neurovascular alterations may increase the risk of nerve injury during subsequent surgeries.