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The Latarjet Procedure May Induce Pathokinematics with Posterior Humeral Head Subluxation: An Experimental Dynamic

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The Latarjet procedure effectively restores glenohumeral joint (GHJ) kinematics under load, mimicking native shoulder motion. However, without anterior load, it may cause posterior humeral head translation, potentially leading to osteoarthritis.

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Shoulder joint kinematics

Background:

  • The Latarjet procedure is effective for stabilizing the abducted and externally rotated glenohumeral joint (GHJ).
  • Limited evidence exists on its ability to restore GHJ kinematics in other positions or without anterior load.
  • This study addresses GHJ kinematics after the Latarjet procedure in shoulders with 15% anterior glenoid bone loss.

Purpose of the Study:

  • To evaluate glenohumeral joint (GHJ) kinematics throughout external rotation following the Latarjet procedure.
  • To assess the effect of 15% anterior glenoid bone loss on GHJ kinematics.
  • To compare kinematics between native GHJ, bone loss, and post-Latarjet states under varying loads.

Main Methods:

  • Eight human donor arms were analyzed using dynamic radiostereometry.
  • GHJ external rotation was assessed under anterior-directed loads (0-30 N) at 30° and 60° abduction.
  • Kinematics were measured for native GHJ, 15% glenoid bone loss, and post-Latarjet conditions.

Main Results:

  • The Latarjet procedure resulted in a more posterior and superior humeral head position compared to 15% bone loss.
  • Under 30 N anterior load, the contact point was more anterior post-Latarjet versus bone loss.
  • No significant kinematic differences were found between native and post-Latarjet GHJ with anterior load; however, without load, posterior and inferior translation occurred post-Latarjet.

Conclusions:

  • The Latarjet procedure restores native GHJ kinematics under anterior-directed loading, particularly at end-range external rotation.
  • Without anterior loading, the Latarjet procedure may lead to excessive posterior and inferior humeral head translation.
  • Potential concerns include posterior glenoid cartilage wear and osteoarthritis, requiring clinical validation.