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. 2024 Mar 13;12(3):23259671241226909.
doi: 10.1177/23259671241226909. eCollection 2024 Mar.

In Vivo 3-Dimensional Dynamic Evaluation of Shoulder Kinematics After the Latarjet Procedure: Comparison With the Contralateral Healthy Shoulder

Jisu Park  1 , Doo Sup Kim  1 , Hyungkyu Huh  2 , Won Gil Cho  3 , HyunWoo Kim  1 , Dong-Woo Lee  4
Affiliations

In Vivo 3-Dimensional Dynamic Evaluation of Shoulder Kinematics After the Latarjet Procedure: Comparison With the Contralateral Healthy Shoulder

Jisu Park et al. Orthop J Sports Med. .

Abstract

Background: Researchers have attempted to understand the underlying mechanism of the Latarjet procedure; however, its effects on shoulder kinematics have not been well studied.

Purpose/hypothesis: The purpose was to analyze shoulder kinematics after the Latarjet procedure. It was hypothesized that the nonanatomic transfer of the coracoid process during the procedure would affect normal shoulder kinematics.

Study design: Controlled laboratory study.

Methods: The study included 10 patients (age range, 20-52 years) who underwent the modified Latarjet procedure between June 2016 and November 2021. Computed tomography and fluoroscopy were conducted on both shoulder joints of all patients, and 3-dimensional models were reconstructed. The 3-dimensional coordinates were encoded on the reconstructed models, and shoulder kinematics were analyzed through a 3-dimensional-2-dimensional model-image registration technique. Scapular rotation parameters (scapular upward rotation, posterior tilt, external rotation, and scapulohumeral rhythm) were compared between the Latarjet and the nonsurgical contralateral sides during humeral abduction, as was anteroposterior (AP) translation relative to the glenoid center during active humeral external rotation.

Results: The Latarjet side displayed significantly higher values of scapular upward rotation at higher degrees of humeral elevation (130°, 140°, and 150°) compared with the nonsurgical side (P = .027). Posterior tilt, external rotation, and scapulohumeral rhythm were not significantly different between sides. AP translation at maximal humeral rotation was not significantly different between sides (Latarjet, -0.06 ± 5.73 mm vs nonsurgical, 5.33 ± 1.60 mm; P = .28). Interestingly, on the Latarjet side, AP translation increased until 40° of humeral rotation (4.27 ± 4.64 mm) but began to decrease from 50° of humeral rotation.

Conclusion: The Latarjet side demonstrated significant changes in scapular upward rotation during higher degrees of humeral elevation compared with the contralateral shoulder. Posterior movement of the humeral head at >50° of humeral rotation could be the desired effect of anterior stabilization; however, researchers should evaluate long-term complications such as osteoarthritis.

Clinical relevance: Analysis of shoulder kinematics after the Latarjet procedure could provide information regarding long-term outcomes and whether the procedure would affect the daily activities of patients.

Keywords: 3D-2D model-image registration technique; Latarjet; scapulohumeral rhythm; shoulder kinematics.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: Grant support was received from the National Research Foundation of Korea funded by the Korean government (NRF-2021R1C1C1003481 to H.H.). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Yonsei University Wonju Severance Christian Hospital (ref No. CR322005).

Figures

Figure 1.
Figure 1.
(A) Representative computed tomography axial image from which the 3D model of the scapula (shaded in gray) and humerus (shaded in blue) was constructed. (B) Reconstructed 3D model showing gray-shaded scapula, blue-shaded humerus, and gold-shaded screw.
Figure 2.
Figure 2.
Three-dimensional models of the (A) shoulder joint, (B) glenoid, and (C) humerus. Upon reconstruction, the anatomic coordinates were applied with Geomagic Studio. The red line is the X-axis; green line, Y-axis; and purple line, Z-axis.
Figure 3.
Figure 3.
Three-dimensional (3D) models with coordinates are encoded on 2-dimensional (2D) fluoroscopic images with the 3D-2D model-image registration technique. (A) Clinical radiograph of a left shoulder after undergoing the Latarjet procedure, and the corresponding 3D model with applied fluoroscopic image at (B) the resting position (palm facing forward, thumb pointing up, and elbow joint extended completely) and (C) maximal abduction. The graphs in parts B and C indicate rotation (rot) and translation (tran) of each axis of the specific model using JointTrack software.
Figure 4.
Figure 4.
Comparison between the Latarjet and nonsurgical sides for scapular rotation parameters according to humeral abduction. (A) Scapular upward rotation, (B) scapular posterior tilt, (C) scapular external rotation, and (D) scapulohumeral rhythm. Error bars indicate standard deviation. *Statistically significant difference between sides (P < .05).
Figure 5.
Figure 5.
Comparison between the Latarjet and nonsurgical sides for humeral anteroposterior (AP) translation relative to the glenoid center according to humeral external rotation. Error bars indicate standard deviation.
See this image and copyright information in PMC

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