Coracoid process transfer for anterior shoulder instability : a pectoralis minor sparing method

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Biomechanics

Background:

• The traditional Latarjet procedure can disrupt scapulothoracic motion due to pectoralis minor release.
• Altering the conjoint tendon's vector is a known consequence of the standard Latarjet approach.

Purpose of the Study:

• To assess a modified Latarjet technique that retains the pectoralis minor insertion and part of the conjoint tendon.
• To evaluate the modified procedure's efficacy in preventing scapular dyskinesis without compromising glenohumeral stability.
• To determine the feasibility of harvesting only the lateral coracoid portion.

Main Methods:

• Retrospective analysis of 9 patients undergoing the modified Latarjet procedure for anterior shoulder instability.
• Assessment of scapulothoracic position and motion, patient satisfaction, Oxford score, and SF-36.
• Radiographic review at minimum 6-month follow-up to evaluate bony union and tendon attachment.

Main Results:

• No instances of scapular dyskinesis were observed post-procedure.
• Radiographs demonstrated a bony spur at the osteotomy site, indicating functional pectoralis minor tendon reattachment.
• The modified technique was technically feasible and effective in treating anterior shoulder instability.

Conclusions:

• Harvesting only the lateral coracoid is a viable modification to the Latarjet procedure.
• This approach successfully avoids scapular dyskinesis while maintaining glenohumeral stability.
• The modified Latarjet procedure offers an effective treatment for anterior shoulder instability with preserved shoulder mechanics.