The Role of Capsular Repair in Latarjet Procedures: Commentary on an article by Yoshiaki Itoigawa, MD, PhD, et al.: "Repairing the Capsule to the Transferred Coracoid Preserves External Rotation in the Modified Latarjet Procedure".

Abstract

The modified Latarjet-Patte procedure1 is thought to provide stability by both the “bone block” effect from the transfer of the coracoid process to the anteroinferior glenoid rim and the “sling effect” produced by the conjoined tendon and the lowered intact subscapularis below2,3. Another possible stabilizing procedure is the repair of the capsule to the transferred portion of the coracoacromial ligament (CAL) after coracoid fixation (capsular-CAL repair). It is unclear whether this has any harmful effects, such as restriction of range of motion. In their biomechanical cadaveric study, Yamamoto et al.3 demonstrated that at the end-range of arm position, capsular-CAL repair contributed 23% of the resistance to translational force, with the remaining 77% provided by the sling effect. At the mid-range of arm position, capsular-CAL repair had no effect on stability, with the sling effect contributing 51% to 62% of the resistance to translational force under increasing load and the remaining 38% to …