Latarjet Procedure With Distal Tibia Allograft Augmentation for Anterior Shoulder Instability in a Convulsive...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Anterior shoulder instability often involves significant bone loss, complicating treatment.
• The Latarjet procedure is a common treatment, but may require augmentation for severe defects.
• Coracoid fracture pseudoarthrosis can further compromise shoulder stability.

Purpose of the Study:

• To describe the combined Latarjet procedure and distal tibia allograft augmentation for complex anterior shoulder instability.
• To evaluate the efficacy of this combined technique in a patient with bipolar bone loss and coracoid pseudoarthrosis.
• To assess patient outcomes and radiographic evidence of graft integration.

Main Methods:

• A 35-year-old female patient with anterior shoulder instability, bipolar bone loss, and coracoid fracture pseudoarthrosis underwent the combined procedure.
• The surgical technique involved a Latarjet procedure utilizing both coracoid autograft and distal tibia allograft for glenoid reconstruction.
• Postoperative management included a 3-week sling immobilization followed by progressive physical therapy.

Main Results:

• At 18 months post-surgery, the patient reported high satisfaction and full functional recovery.
• No recurrence of shoulder dislocations was observed.
• Radiographic assessment confirmed successful graft positioning and bone integration without complications.

Conclusions:

• The combined Latarjet procedure with distal tibia allograft augmentation is an effective solution for complex anterior shoulder instability with substantial bone loss.
• This technique provides a robust method for glenoid reconstruction when autograft sources are insufficient.
• The approach offers a promising option for restoring shoulder stability and function in challenging cases.