In Vivo 3-Dimensional Dynamic Evaluation of Shoulder Kinematics After the Latarjet Procedure: Comparison With the Contralateral Healthy Shoulder.

Abstract

Researchers have attempted to understand the underlying mechanism of the Latarjet procedure; however, its effects on shoulder kinematics have not been well studied. The purpose was to analyze shoulder kinematics after the Latarjet procedure. It was hypothesized that the nonanatomic transfer of the coracoid process during the procedure would affect normal shoulder kinematics. Controlled laboratory study. The study included 10 patients (age range, 20-52 years) who underwent the modified Latarjet procedure between June 2016 and November 2021. Computed tomography and fluoroscopy were conducted on both shoulder joints of all patients, and 3-dimensional models were reconstructed. The 3-dimensional coordinates were encoded on the reconstructed models, and shoulder kinematics were analyzed through a 3-dimensional-2-dimensional model-image registration technique. Scapular rotation parameters (scapular upward rotation, posterior tilt, external rotation, and scapulohumeral rhythm) were compared between the Latarjet and the nonsurgical contralateral sides during humeral abduction, as was anteroposterior (AP) translation relative to the glenoid center during active humeral external rotation. The Latarjet side displayed significantly higher values of scapular upward rotation at higher degrees of humeral elevation (130°, 140°, and 150°) compared with the nonsurgical side (P = .027). Posterior tilt, external rotation, and scapulohumeral rhythm were not significantly different between sides. AP translation at maximal humeral rotation was not significantly different between sides (Latarjet, -0.06 ± 5.73 mm vs nonsurgical, 5.33 ± 1.60 mm; P = .28). Interestingly, on the Latarjet side, AP translation increased until 40° of humeral rotation (4.27 ± 4.64 mm) but began to decrease from 50° of humeral rotation. The Latarjet side demonstrated significant changes in scapular upward rotation during higher degrees of humeral elevation compared with the contralateral shoulder. Posterior movement of the humeral head at >50° of humeral rotation could be the desired effect of anterior stabilization; however, researchers should evaluate long-term complications such as osteoarthritis. Analysis of shoulder kinematics after the Latarjet procedure could provide information regarding long-term outcomes and whether the procedure would affect the daily activities of patients.