LATARJET EFFECT: IS IT REALLY RELATED TO THE CORACOID BLOCK ?

Purpose: Surgical treatment of anterior shoulder instability relies heavily on the Latarjet procedure which uses a coracoid block fixed to the anteroinferior rim of the glenoid. The procedure is technically difficult, leading to a substantial number of intraoperative complications, block nonunions and partial lysis, and most importantly long-term scapular osteoarthritis. Nevertheless, in certain cases, complete lysis or removal of the block does not alter stability. Furthermore, the current technique requires partial section or discision of the subscapular fibres, the only healthy element which persists anteriorly. The question is thus whether the greatest stabilising effect arises from the hammock effect of the coracobiceps on the subscapular. We report our experience with a prospective series.Material and methods: We initiated a prospective study in 1997 in a series of patients treated by simple section of the coracobiceps, leaving the acromiocoracoid, coracoid, and subscapular ligaments totally intact....