Modified arthroscopic latarjet procedure with open coracoid removal, a “between both” technique

Abstract

The arthroscopic Latarjet procedure includes arthroscopic transfer of the coracoid and biceps tendon to the anterior glenoid. We are developing a modified method to facilitate the procedure and minimize the risk of injury to the brachial plexus. The coracoid is detached and exteriorized through the antero-inferior portal for preparing. A specific coracoid guide (Newclip) is used to make 2 drill holes in the coracoid for fixation, to facilitate coracoid transfer and serve as a pin guide for fixation. We evaluate 18 patients operated in 2014-2015 with a minimum of 1-year follow-up. In ten patients, high-level rugby players we associate antero-inferior capsular shift. They had only mild to moderate postoperative pain. There were no postoperative infections or recurrent dislocations. The safety of this operation was similar to that of other operations on the coracoid process in the proximity of the brachial plexus. The modified arthroscopic Latarjet procedure may be applied successfully to the treatment of anterior glenohumeral instability, with good patient satisfaction and functional outcome.