Latarjet coracoid position

I attended the Matcalf / AANA course in Snowbird last week and had an interesting discussion and then interview with Dr. Giovanni DiGiacomo from Rome. He developed a plate for the coracoid to meet two needs. 1. Support against possible screw cut out. 2. The coracoid in the traditional position does not always lie flush to the angled surface of the anterior scapular neck. His plate is built up on one side so that it applies force unevenly, compresses the coracoid medially and helps it lie flat against the anterior scapular neck. He has wonderful animations and video from surgery but I have not tried it yet. I spoke to my local Arthrex rep today. I have done the traditional Latarjet as explained to me by Gilles Walch and recently have tried the medial side down, congruent arc technique of Burkhart and Joe DeBeers. The congruent arc technique is aptly named as the medial side fits the glenoid rim perfectly. The downside is that the coracoacromial ligament is no longer intra-articular. Does this matter?

About g9md

CEO and Medical Director G9MD.com
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One Response to Latarjet coracoid position

  1. I think that you don’t need to repair the coracoacromial ligament on the capsula, if you perform an horizontal split of the capsula you can repair the capsula from lateral to medial till the common tendon, at the same time I think you don’t need the medial side down of the coracoid but I prefer to make the coracoid lie down on the glenoid neck as Gilles does.
    In my personal experience, the plate is working because of the medial wedge but also because the “lag effect” of the screws depends on the contact between the screws head and plate (that of course is better than screws and coracoid bone) and always pay attention that the distal screws are in the posterior cortex of the glenoid, this give you the best compression.
    But my question is: how much compression do we need to have the best bone-to-bone healing?

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