The Bristow and Latarjet Procedures: Why These Techniques Should Not Be Considered Synonymous
Bibliographic record
Abstract
BACKGROUND: Recurrent shoulder instability is commonly associated with glenoid bone defects. Coracoid transfer procedures, such as the Bristow and Latarjet procedures, are frequently used to address these bone deficiencies. Despite the frequent synonymous labeling of these transfers as the "Bristow-Latarjet" procedure, their true equivalence has not been demonstrated. Therefore, our purpose was to compare the biomechanical effects of these two procedures. METHODS: Eight cadaveric specimens were tested on a custom shoulder simulator capable of loading nine muscle groups and of accurately orienting the joint throughout shoulder motion. The specimens were tested in the intact state, following Bristow and Latarjet reconstructions of a capsulolabral injury (0% glenoid defect), and following each procedure after creation of 15% and 30% glenoid bone defects. The reconstruction order was randomized. In each condition, joint stiffness (anterior stability) and occurrence of dislocation were assessed in shoulder adduction and abduction with neutral and external rotation. RESULTS: No significant differences (p < 0.05) in joint stiffness or stability were found between the Bristow and Latarjet reconstructions for the 0% glenoid defect in any joint position. However, substantially greater joint stiffness occurred following the Latarjet procedure, as compared with the Bristow procedure, for the 15% and 30% glenoid bone-loss conditions in adduction with neutral rotation, adduction with external rotation, and abduction with external rotation (average across the three joint positions: 8.6 ± 4.4 N/mm versus 3.9 ± 1.26.7 N/mm [p = 0.034] with 15% bone loss and 7.5 ± 4.4 N/mm versus 3.4 ± 1.5 N/mm [p = 0.045] with 30% bone loss). The Latarjet reconstruction restored the stiffness that had been measured in the intact state in eleven of the twelve tested conditions, whereas the Bristow procedure was successful in only four of the twelve conditions. In addition, during instability testing, three more specimens dislocated following the Bristow reconstruction, compared with the Latarjet procedure, in the 15% defect condition and five more dislocated in the 30% defect condition. CONCLUSIONS: The Bristow and Latarjet procedures are not equivalent in terms of their effects on glenohumeral joint stiffness and stability in cases of glenoid osseous deficiency. CLINICAL RELEVANCE: The Bristow and Latarjet procedures have equivalent stabilizing effects in unstable shoulders with preserved glenoid osseous anatomy. However, the Latarjet procedure confers superior stabilization in the setting of substantial glenoid bone loss.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.010 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.008 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".