title: Biomechanical comparison of open and arthroscopic Latarjet procedures.
abstract: OBJECTIVE
  To biomechanically compare the effectiveness of the standard open and arthroscopic techniques of the Latarjet procedure to address a critical anterior glenoid defect in combination with a capsular insufficiency.
  
  
  METHODS
  Translation testing of 12 human cadaveric shoulder specimens was performed in a robot-assisted setup under 3 different conditions: (1) intact/vented shoulder joint, (2) combined anterior glenoid bone and capsular defect, and (3) open and arthroscopic Latarjet procedures. Testing was performed for each condition in 2 test positions: 60° of glenohumeral abduction with neutral rotation (ABD position) and 60° of abduction and external rotation (ABER position). Each position was tested with a passive humerus load of 30 N in the anterior, inferior, and anteroinferior directions. Translational movement of the humeral head was evaluated with and without the application of a 10-N load to the conjoint tendon (CJT).
  
  
  RESULTS
  In the ABD position, translations after the open Latarjet procedure significantly differed from the arthroscopic technique in the anterior and anteroinferior directions when testing was performed with loading of the CJTs (CJT loading). Without CJT loading, the open Latarjet technique showed significantly lower translations in the anterior, inferior (P = .004), and anteroinferior (P = .001) testing directions in the ABD position. In the ABER position, the arthroscopic procedure showed no significant difference compared with the standard open procedure.
  
  
  CONCLUSIONS
  We found a superior stabilization effect of the open Latarjet technique in the ABD position. The difference is ascribed to the anterior capsular repair, which was performed within the open technique and omitted during the arthroscopic procedure.
  
  
  CONCLUSIONS
  The reduction of translation in a pure abduction position of the arm is more effectively performed with a conventional open Latarjet technique that includes a capsular repair. In combined ABER position, there was no difference found between the open and arthroscopic Latarjet techniques.
authors: Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany.
authors: Johanna
authors: J
authors: Schulze-Borges
authors: Jens D
authors: JD
authors: Agneskirchner
authors: Evgenij
authors: E
authors: Bobrowitsch
authors: Thilo
authors: T
authors: Patzer
authors: Melena
authors: M
authors: Struck
authors: Tomas
authors: T
authors: Smith
authors: Mathias
authors: M
authors: Wellmann
mesh_terms: D000368:Aged; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology* / Q000601:surgery*