A hybrid open-arthroscopic latarjet coracoid bone-block technique using "HyLa" instrumentation

Abstract

Latarjet coracoid bone-block is a gold-standard procedure for anteroinferior instability of the shoulder. Nowadays, it can be performed as open surgery or entirely under arthroscopy. The pure arthroscopic technique has the advantage of allowing concomitant intra-articular surgery, but involves a long learning curve. Here we present a hybrid concept using dedicated instrumentation comprising a specific guide with or without arthroscopic step, and notably ensuring the safety and reproducibility of the procedure, whatever the modality. This technique offers an alternative to arthroscopic coracoid bone block, performing the more complex steps as open surgery without major change to Latarjet's original technique, so as to enable concomitant intra-articular surgery if needed while getting around some of the limitations of the purely arthroscopic procedure.

Keywords: Arthroscopic Latarjet; Bankart repair; Glenohumeral instability; Hill-Sachs remplissage; HyLa; Latarjet; Shoulder instability.