Open Latarjet with Metal-Free Cerclage Fixation

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• The Latarjet procedure is a common surgical treatment for recurrent anterior shoulder instability, particularly when associated with glenoid bone loss.
• However, graft resorption and prominence of metallic hardware are known complications, potentially leading to soft-tissue impingement and revision surgery.
• Minimizing technical difficulties and morbidity associated with traditional metallic implants is an ongoing challenge in shoulder reconstruction.

Purpose of the Study:

• To describe a modified coracoid and conjoint tendon transfer technique using cerclage tape suture as an alternative to the standard Latarjet procedure.
• To evaluate this mini-open approach as a method to reduce complications associated with metallic hardware in treating anterior shoulder instability with bone loss.

Main Methods:

• A mini-open surgical approach was utilized for coracoid and conjoint tendon transfer.
• Cerclage tape suture was employed as the fixation method, avoiding the use of traditional metal screws and plates.
• This technique was presented as an alternative to the conventional Latarjet procedure for managing recurrent anterior shoulder instability with glenoid defects.

Main Results:

• The described technique offers a potential solution to mitigate graft resorption and hardware-related complications seen with the Latarjet procedure.
• The use of cerclage tape suture aims to reduce the risk of hardware prominence and anterior soft-tissue impingement.
• This approach may offer a less morbid alternative for surgeons treating complex shoulder instability.

Conclusions:

• The coracoid and conjoint tendon transfer with cerclage tape represents a viable alternative to the Latarjet procedure for anterior shoulder instability with bone loss.
• This technique has the potential to decrease complications related to metallic implants and graft resorption.
• Further clinical studies are warranted to validate the long-term efficacy and safety of this innovative surgical approach.