Mini-open arthroscopically assisted Bristow-Latarjet procedure for the treatment of patients with anterior shoulder instability: a cadaver study.
OBJECTIVE
The purpose of this study was to evaluate the arthroscopically assisted Bristow-Latarjet procedure. The aim was to use arthroscopic guidance to assist in positioning of the coracoid bone block onto the anterolateral aspect of the glenoid. The feasibility of this technique and its efficacy, reproducibility, and potential neurovascular complications were evaluated.


METHODS
A minimally invasive technique was used to harvest the coracoid bone block and the attached coracobiceps tendon. A portal was created through the subscapularis muscle and, under arthroscopic guidance, the anterior aspect of the glenoid was cleaned and reamed before the bone block was placed. Cannulated screws (3.5 mm) were used to fix the vertically oriented bone block to the glenoid. The size of the bone block, its position on the glenoid, and its relation to the subscapularis tendon and the musculocutaneous and axillary nerves were recorded.


RESULTS
In all 5 cadavers, the bone block was well positioned and was fixed to the anteroinferior part of the glenoid. No lesions of the cephalic vein or of the surrounding neurovasculature were observed.


CONCLUSIONS
This study demonstrated the safe and effective use of this arthroscopically assisted technique for correct positioning of the coracoid bone block at the anterolateral aspect of the glenoid in the cadaveric shoulder. Arthroscopy facilitated adequate reaming of the anterior glenoid and aided in optimal positioning of the bone block.


CONCLUSIONS
This cadaveric study highlights the advantages offered by an arthroscopically assisted Bristow-Latarjet procedure, which optimizes positioning of the block and ensures adequate reaming of the anterior glenoid, thereby potentially reducing the risks of early nonunion and late arthritis--complications commonly associated with the classical Bristow-Latarjet technique.
Nourissat
Geoffroy
G
Service de Chirurgie Orthopédique, Hôpital Saint Antoine Université Paris VII, Paris, France. gnourissat@wanadoo.fr
Nedellec
Guillaume
G
O'Sullivan
Niamh A
NA
Debet-Mejean
Aurore
A
Dumontier
Christian
C
Sautet
Alain
A
Doursounian
Levon
L
D001182:Arthroscopy / Q000379:methods*; D001863:Bone Screws; D002102:Cadaver; D005240:Feasibility Studies; D006801:Humans; D006811:Humerus / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D010003:Osteoarthritis / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D012540:Scapula / Q000601:surgery*; D012785:Shoulder Joint