• BACKGROUND
    • To address glenoid bone deficiency, 2 competing surgical approaches are currently recommended: transplantation of a structural bone graft or the coracoid transfer according to Latarjet. Nonetheless, no clear advantages for either procedure are evident.
  • HYPOTHESIS
    • The Latarjet procedure will provide an equivalent beneficial effect on glenohumeral stability as the placement of an intra-articular bone graft.
  • STUDY DESIGN
    • Controlled laboratory study.
  • METHODS
    • Stability testing of 8 cadaveric shoulders was performed in a dynamic shoulder simulator under 4 different conditions: (1) anteroinferior capsulotomy, (2) anteroinferior glenoid defect, (3) transplantation of a contoured bone graft, and (4) Latarjet procedure. Translational movement of the humeral head in response to a load of 25 N was evaluated in the anterior and anteroinferior directions.
  • RESULTS
    • The Latarjet procedure significantly reduced translation by 354% relative to the glenoid defect condition at 30 degrees of abduction and by 374% at 60 degrees of abduction. In comparison, the bone graft significantly reduced translation by 179% at 30 degrees of abduction and by 159% at 60 degrees of abduction. The effect of the bone graft was lowest in external rotation at 60 degrees of abduction where a decrease of translation of 133% was observed. Comparing both reconstruction techniques, the Latarjet procedure resulted in significantly less anterior and anteroinferior translation at 60 degrees of abduction.
  • CONCLUSION
    • Biomechanically, the Latarjet procedure outperforms the bone graft in reducing translation in anteroinferior glenoid bone defects. The advantage of the Latarjet procedure is particularly evident at 60 degrees of glenohumeral abduction.
  • CLINICAL RELEVANCE
    • On the basis of the results of this biomechanical study, the authors recommend the Latarjet procedure for restoring stability in shoulders with a significant glenoid bone defect.