Saithna Adnan
Arthroscopy. 2025 Jan;41(1):29-31. doi: 10.1016/j.arthro.2024.05.017. Epub 2024 Jun 4.
The Latarjet procedure was first described in 1954. It is a nonanatomic procedure that requires transfer of the coracoid process, together with the conjoint tendon, to the anterior glenoid margin. The aim is to prevent recurrent anterior shoulder dislocation through a "triple blocking" effect, which includes restoring bone loss, providing a dynamic sling effect, and performing capsulolabral repair. Despite the long history of the Latarjet procedure, studies evaluating its impact on scapulothoracic kinematics are sparse. However, there is a concern that scapulothoracic dyskinesia may occur owing to anatomic changes, including release of the coracoacromial ligament and pectoralis minor tendon, a change in the working length and vector of the conjoint tendon, subscapularis split, and capsular closure. The existing literature has major limitations and comprises predominantly small conflicting series that identify either no scapulothoracic dyskinesia after Latarjet or the presence of scapular protraction or retraction. Given that scapular dyskinesia is very common in shoulder instability patients and even asymptomatic general populations, the evidence that the Latarjet procedure results in dyskinesia is not compelling.
拉塔热手术于1954年首次被描述。它是一种非解剖学手术，需要将喙突连同联合腱转移至肩胛盂前缘。其目的是通过“三重阻挡”效应防止复发性肩关节前脱位，该效应包括修复骨质缺损、提供动态吊带效应以及进行关节囊盂唇修复。尽管拉塔热手术历史悠久，但评估其对肩胛胸壁运动学影响的研究却很少。然而，人们担心由于解剖结构的改变可能会出现肩胛胸壁运动障碍，这些改变包括喙肩韧带和胸小肌腱的松解、联合腱工作长度和方向的改变、肩胛下肌劈开以及关节囊闭合。现有文献存在重大局限性，主要包括一些相互矛盾的小样本系列研究，这些研究要么表明拉塔热手术后不存在肩胛胸壁运动障碍，要么表明存在肩胛前伸或后缩。鉴于肩胛运动障碍在肩关节不稳定患者甚至无症状普通人群中都非常常见，拉塔热手术导致运动障碍的证据并不确凿。
