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Record W2976096799 · doi:10.2106/jbjs.st.18.00025

Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability

2019· article· en· W2976096799 on OpenAlexaff
Jarret M. Woodmass, Eric R. Wagner, Muriel J. Solberg, Tyler J. Hunt, Laurence D. Higgins

Bibliographic record

VenueJBJS Essential Surgical Techniques · 2019
Typearticle
Languageen
FieldMedicine
TopicShoulder Injury and Treatment
Canadian institutionsUniversity of ManitobaPan Am Clinic
Fundersnot available
KeywordsLatarjet procedureCoracoidMedicineAnterior shoulderCoracoid processRotator cuffSurgeryAnatomyScapula

Abstract

fetched live from OpenAlex

Anterior glenohumeral instability is common, with 21.9 first-time dislocations per 100,000 individuals per year. Recurrent instability is more likely to occur in patients who are younger, of male sex, and have bone defects or ligament laxity. The open Latarjet procedure is effective for the treatment of recurrent anterior glenohumeral instability and is preferred over arthroscopic Bankart repair in the presence of glenoid bone loss. The Latarjet procedure involves transferring the coracoid to the anterior aspect of the glenoid in the following steps. Step 1: Preoperative planning includes an assessment of glenoid deformation and the integrity of the rotator cuff. The degree of bone loss is measured with use of the circle-line method. Step 2: The patient is in the beach-chair position with the arm in a pneumatic arm holder. A parallel drill guide system with 3.75-mm cannulated screws is utilized. Step 3: A 5-to-6-cm incision is made along the anterior axillary line. The deltopectoral interval is established, and the cephalic vein is mobilized laterally. The coracoacromial ligament is transected 15 mm lateral to the coracoid to allow later repair to the anterior capsule. The pectoralis minor is released subperiosteally off the medial coracoid. A 90° oscillating saw is used to transect the coracoid medially to laterally. The coracohumeral ligament is released. Step 4: Two 4.0-mm drill-holes are made 1 cm apart through the coracoid. The undersurface is decorticated. Step 5: The subscapularis is split at the junction of the upper two-thirds and lower one-third. A longitudinal capsulotomy is performed parallel to the glenoid. Step 6: Soft tissue, including the capsule and labrum, is removed from the anterior aspect of the glenoid. The bone is decorticated with an osteotome and a rasp. Step 7: The coracoid is positioned flush or 1 mm recessed relative to the glenoid. Two 1.6-mm guidewires are placed with use of a parallel drill guide followed by a cannulated reamer and two 3.75-mm cannulated screws. Step 8: The coracoacromial ligament is repaired to the capsule. Step 9: The subscapularis split is repaired laterally. The deltopectoral interval and skin are closed in a standard fashion. A standardized rehabilitation protocol is employed postoperatively. The Latarjet procedure results in significantly lower rates of recurrent glenohumeral instability and revision compared with the arthroscopic Bankart procedure (3% and 1% compared with 28.4% and 21%, respectively); however, complication rates as high as 30% have been reported, as well as a risk for nerve injury. The videos included in this article highlight the critical steps required to optimize outcomes and minimize complications when performing the Latarjet procedure.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Bench or experimental · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.619
Threshold uncertainty score0.408

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.019
GPT teacher head0.344
Teacher spread0.325 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designBench or experimental
Domainnot available
GenreEmpirical

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".

Quick stats

Citations16
Published2019
Admission routes1
Has abstractyes

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