Surgical treatment of post-traumatic instability of the shoulder joint in athletes. Аrthroscopic Latarjet procedure or free bone autograft?

Abstract

BACKGROUND: Surgical therapy for post-traumatic shoulder includes a variety of procedures, such as the Latarjet operation, Bankart, and the use of free bone autograft. Each of the offered approaches has advantages and disadvantages. As a result, techniques for plastic surgery of the articular surface of the scapula have been developed in the last 10 yr.

OBJECTIVE: To comprehensively evaluate the outcomes of biomechanical studies of the shoulder joint in the postoperative period after arthroscopic Latarjet operation and arthroscopic stabilization using a free bone graft in professional athletes.

MATERIALS AND METHODS: From 2017 to 2022, the Clinic for Sports, Ballet, and Circus Trauma, named after Z.S. Mironova (N.N. Priorov National Medical Research Center for Traumatology and Orthopedics), performed 27 arthroscopic procedures on patients with post-traumatic shoulder joint instability.

RESULT: According to the results of a comparative study of the biomechanics of the shoulder joint in the postoperative period in 27 athletes, conducted by us in the scientific department of medical rehabilitation of the N.N. Priorov, under the guidance of I.S. Kosov, it was revealed that the use of arthroscopic Latarjet operation reduces the strength characteristics of the shoulder joint and violates proprioceptive sensitivity, resulting to fine coordination of movements.

CONCLUSIONS: The surgical treatment of post-traumatic shoulder joint instability in athletes is determined by the sport. A free bone block allows you to maintain fine coordinated movements, which is vital in gymnastics, synchronized swimming, and other sports, and a free autograft does not reduce strength characteristics after surgery. The Latarjet operation can be used in team sports (basketball and volleyball) without affecting the outcome of the game.

Keywords

post-traumatic instability / shoulder arthroscopy / Latarjet operation / free bone block

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