Dataset Information

Arthroscopic Transfer of the Conjoined Tendon-Coracoid Tip Complex for Anterior Shoulder Instability.

ABSTRACT: In the treatment of anterior shoulder instability, there are various conditions in which a sling effect is needed to enhance anterior stability. The traditional Bristow-Latarjet procedure provides a sling effect but destroys or does not purposely protect the coracoacromial (CA) arch, which may result in superior instability. To preserve the CA arch and create a sling to enhance the anterior-inferior side of the shoulder, we introduce an arthroscopic technique to transfer the conjoined tendon-coracoid tip complex (CTCTC) with the intention to keep the CA ligament intact to the utmost. The indications for CTCTC transfer are patients younger than 45?years who participate in competitive sports, require forceful external rotation and abduction movements of the shoulder, and/or have capsule-ligament insufficiency. The main steps of this procedure include detaching the CTCTC, fashioning the coracoid tip to obtain a coracoid pillar, braiding the CTCTC, creating a glenoid tunnel and socket, placing a guide suture through the glenoid tunnel and subscapularis, passing the CTCTC through the subscapularis and into the glenoid socket, and performing suspension fixation of the CTCTC.

SUBMITTER: Tang J

PROVIDER: S-EPMC5852246 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Arthroscopic Transfer of the Conjoined Tendon-Coracoid Tip Complex for Anterior Shoulder Instability.

Tang Jin J Zhao Jinzhong J

Arthroscopy techniques 20171218 1

In the treatment of anterior shoulder instability, there are various conditions in which a sling effect is needed to enhance anterior stability. The traditional Bristow-Latarjet procedure provides a sling effect but destroys or does not purposely protect the coracoacromial (CA) arch, which may result in superior instability. To preserve the CA arch and create a sling to enhance the anterior-inferior side of the shoulder, we introduce an arthroscopic technique to transfer the conjoined tendon-cor ...[more]

PMID: 29552466

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Project description:BackgroundShoulder dislocations can be devastating for an athlete. Coracoid bone block transfer is often used for the treatment of recurrent shoulder instability.Questions/purposesThe primary purpose of this study was to determine the rate and mean time of return to sport in athletes after a coracoid bone block transfer at the pre-operative level of competition, a lower level, or a different level. We also sought to determine how return to sport rates after a coracoid bone block procedure compared with rates after several comparator interventions. Finally, we looked to determine the post-operative clinical outcomes and complications reported after a coracoid bone block procedure.MethodsWe systematically searched three databases (PubMed, Embase, and MEDLINE) for studies reporting return to sport after a coracoid bone block procedure.ResultsA total of 52 studies (with levels of evidence ranging from II to IV) evaluating 2953 shoulders in 2888 patients were included in this systematic review. The mean rate of return to sport at any level was 88.4% (2291 of 2592 patients). However, the rate of return to the pre-operative level was 70.3% (1387 of 1974 patients). The mean time to return to sport was 5.38 months (range 21 days to 36 months). The rate of return to sport was higher after the Latarjet procedure, as compared with Bankart repair (87.0% and 75.8%, respectively). All studies showed improvements in clinical outcome measures after coracoid bone block intervention. The cumulative complication rate was found to be 6.46% (158 of 2446 patients).ConclusionCoracoid bone block transfer allows for a high rate of return to sport, although the rate of return to sport at athletes' pre-operative level is lower. The rate of return to sport after Latarjet procedure is higher in comparison with Bankart repair. Additionally, coracoid bone block transfer is associated with improvements in a number of clinical outcome measures. Common post-operative complications include non-union between bone block and glenoid, hematoma, and infection.

Dataset Information

Arthroscopic Transfer of the Conjoined Tendon-Coracoid Tip Complex for Anterior Shoulder Instability.

Publications

Arthroscopic Transfer of the Conjoined Tendon-Coracoid Tip Complex for Anterior Shoulder Instability.

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