title: Scapular dyskinesis after Latarjet procedure.
abstract: BACKGROUND
  Because of detachment of the pectoralis minor and variation of the vector of the conjoint tendons, we hypothesized that the Latarjet procedure may alter scapular position and motion. The purpose of this study was to evaluate scapular position and motion in patients who underwent a Latarjet or a modified iliac crest bone graft transfer (ICBGT) procedure (J-bone graft).
  
  
  METHODS
  Forty-six consecutive patients treated for recurrent anterior shoulder dislocation between 2010 and 2012 were retrospectively enrolled. Twenty-three were treated with a Latarjet and 23 with an ICBGT procedure. Twenty Latarjet and 20 ICBGT patients were available at a mean follow-up of 20 months (min, 12; max, 60). We recorded the Western Ontario Instability Index, the Rowe Score, and the Subjective Shoulder Value. Scapulothoracic position was studied according to the dyskinesis yes/no method. Intraobserver and interobserver reliability of the dyskinesis assessment was assessed.
  
  
  RESULTS
  Intraobserver and interobserver reliability of scapula dyskinesis assessment was high (Latarjet: intratester, κ = 0.84; intertester, κ = 0.75; ICBGT: intratester, κ = 0.78; intertester, κ = 0.71). Scapular dyskinesis was observed after 5 of 20 Latarjet and after 0 of 20 ICBGT procedures (P = .047). Patients with dyskinesis had lower scores (Western Ontario Instability Index, P = .043; Rowe, P = .047; Subjective Shoulder Value, P = .046), but no statistically significant difference was found between the Latarjet and ICBGT groups. Two of the 5 scapular dyskinesis patients reached the SICK (Scapular malposition, Inferior medial scapular winging, Coracoid tenderness, and scapular dysKinesis) scapula syndrome definition.
  
  
  CONCLUSIONS
  Scapular dyskinesis was found in 5 of 20 patients who underwent a Latarjet procedure. Dyskinesis may be related to the detachment of the pectoralis minor, and variation of the vector and the working length of the coracobrachialis and the short head of the biceps.
authors.affiliation: Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: stefcarbone@yahoo.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Carbone
authors.affiliation: Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Moroder
authors.affiliation: Medizinische Universitat Innsbruck, Innsbruck, Austria.
authors.forename: Armin
authors.initials: A
authors.lastname: Runer
authors.affiliation: Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Resch
authors.affiliation: Department of Anatomical, Histological, Forensic, Medicine and Orthopedic Science, Sapienza University of Rome, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gumina
authors.affiliation: Schulter & Ellbogen Zentrum, Lindenhofspital, Bern, Switzerland.
authors.forename: Ralph
authors.initials: R
authors.lastname: Hertel
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000009:adverse effects* / Q000379:methods; D002648:Child; D020820:Dyskinesias / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010369:Pectoralis Muscles / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012540:Scapula / Q000503:physiopathology*; D012783:Shoulder Dislocation / Q000601:surgery*; D055815:Young Adult
keywords: Eden procedures; J-bone graft; Latarjet procedure; Scapular dyskinesis; complications; modified iliac crest bone graft transfer procedure; scapular position