Do the Traditional and Modified Latarjet Techniques Produce Equivalent Reconstruction Stability and Strength?
Bibliographic record
Abstract
BACKGROUND: The Latarjet procedure has been described as a reconstructive option for instability associated with substantial glenoid bone defects. A modification, termed the Congruent-Arc, is thought to improve glenoid reconstruction through better articular congruency and greater bone reconstitution. The strengths of these techniques, however, have not been reported. Purpose/ HYPOTHESIS: To compare the fixation stability, strength, glenoid vault load transfer, and joint contact between the Classic and Congruent-Arc techniques. The authors hypothesized that the Classic Latarjet would exhibit inferior joint contact characteristics while having greater stability and strength and more normal glenoid vault strain. STUDY DESIGN: Controlled laboratory study. METHODS: Sixteen shoulder specimens (8 pairs) were tested by loading the glenohumeral joint with the glenoid intact, following creation of a 25% anterior bone defect, and after random assignment to the Classic or Congruent-Arc Latarjet techniques. Specimens were mounted to a testing apparatus that allowed concentric, centralized loading and loading 30° anterior on the glenoid rim. Cyclic loading (100 cycles at 1 Hz) was applied with a staircase protocol (50, 100, 150, and 200 N). Graft interface displacement and glenoid load transfer, quantified in terms of strain, were recorded during loading. Contact was quantified during 50-N loading using a thin pressure sensor. After cyclic loading, specimens were loaded to failure, defined as 5 mm of graft interface displacement. RESULTS: The 30° loading ≥100 N resulted in significantly greater graft displacement (P < .004) in the Congruent-Arc group as compared with the Classic (mean displacement range, 0.9-2.6 vs 0.1-0.5 mm, respectively). Failure testing yielded a significantly (P = .010) greater ultimate strength for the Classic (557 N) as compared with the Congruent-Arc (392 N). Load-transfer measurements demonstrated that neither technique's glenoid vault strain values significantly differed from intact (P ≥ .076). Both techniques resulted in contact areas significantly less than intact (P < .035); however, the Congruent-Arc trended toward better contact characteristics (P = .074). CONCLUSION: The Congruent-Arc results in significantly poorer fixation stability as compared with the Classic technique but did more closely reproduce intact joint contact, which may yield more favorable long-term outcomes. CLINICAL RELEVANCE: Care must be taken in balancing the consideration of initial fixation stability and joint contact for the Congruent-Arc and Classic Latarjet, as these factors have opposing implications for each of the 2 reconstructions' outcomes.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".