Structural, Functional Integrity Intact After Latarjet

The structural and functional integrity of the subscapularis and conjoint tendon remain intact after Latarjet Procedure, according to a new study.

In the study, “Structural and Functional Results of Subscapularis and Conjoint Tendon After Latarjet Procedure at 8-Year Average Follow-up,” researchers examined shoulder stability 8 years after the Latarjet procedure.

They wrote that the eventual structural and functional integrity of the subscapularis and conjoint tendons prior to these findings were unknown.

The findings were published online on December 22, 2021, in The American Journal of Sports Medicine.

Twenty patients with anterior shoulder instability who underwent open Latarjet procedure were included in the study. The mean age was 30 years (range, 19-50 years). The research team collected quantitative isometric measurements of abduction and internal rotation strength and compared that data with data from the nonoperative side and the final position and healing of the transferred coracoid bone block.

The subscapularis and conjoint tendon were evaluated using MRI with metal artifact reduction techniques and ultrasound.

Overall, 19 of the 20 shoulders remained stable at the final follow-up. There was 1 re-dislocation after 14 months.

The mean Rowe score was 83 points (SD, 17.9 points), the mean Constant score was 85 points (SD, 8.1 points) and the Subjective Shoulder Value was 80% (SD, 18%). And the mean abduction strength of the operative shoulder was 7.41 ± 2.06 kg compared with 8.33 ±2.53 kg for the nonoperative side (p = .02).

The mean internal rotation strength at 0° for the operative shoulder was 8.82 ± 3.47 kg compared with 9.06 ± 3.01 kg for the nonoperative side (p = .36). The mean internal rotation strength in the belly-press position for the operative shoulder was 8.12 ± 2.89 kg compared with 8.50 ± 3.03 kg (p = .13).

Four of the 20 shoulders showed mild tendinopathic changes of the subscapularis tendon, but no partial or complete tear. One patient demonstrated fatty degeneration Goutallier stage 1. The conjoint tendon was in continuity in all 20 shoulders on MRI scans.

“Abduction, but not internal rotation strength, was slightly reduced after the Latarjet procedure at a mean of 8 years follow-up. The subscapularis tendon was intact based on ultrasound examination, and the conjoint tendon was intact based on MRI scans. Subscapularis muscle girth relative to the supraspinatus muscle remained intact from preoperative measurements based on MRI scans,” the researchers wrote.

Study authors included Sebastien Azizi, M.D., Lukas Urbanschitz, M.D., Susanne Bensler, M.D., Christopher G. Lenz, M.D., and Karim Eid, M.D., of Kantonsspital Baden in Baden, Switzerland. And Paul Borbas, M.D. of Uniklinik Balgrist in Zunich, Switzerland.