This prospective case series describes a novel all-arthroscopic technique combining a Bristow-Latarjet coracoid transfer with a Bankart repair for anterior instability. It targets patients with glenoid bone loss and capsular deficiency, including failed prior capsulolabral repairs. The study asks whether the arthroscopic approach is safe, reproducible, and capable of accurate bone block placement.
When a patient with recurrent anterior instability has significant glenoid bone loss or capsular deficiency, an isolated arthroscopic Bankart repair will fail. Use the ISIS to flag these patients: a score above 3 pushes you toward a bony procedure.
This paper establishes that the Latarjet can be performed arthroscopically with placement accuracy that beats historical open series, where malposition has run as high as 50%.
The teaching point is the "triple blocking" mental model. Stability comes from three sources: the labral bumper, the coracoid bone block restoring glenoid arc, and the conjoined-tendon belt effect that tensions subscapularis in the throwing position.
Weigh the evidence carefully. This is a Level IV single-surgeon series at only 16 months with a 17% nonunion/migration rate and a steep learning curve requiring staged progression from open to mini-open to arthroscopic. Adding a Bankart to the Latarjet is defensible because isolated Latarjet leaves roughly 30% of patients with persistent apprehension.
This prospective case series describes a novel all-arthroscopic technique combining a Bristow-Latarjet coracoid transfer with a Bankart repair for anterior instability. It targets patients with glenoid bone loss and capsular deficiency, including failed prior capsulolabral repairs. The study asks whether the arthroscopic approach is safe, reproducible, and capable of accurate bone block placement.
When a patient with recurrent anterior instability has significant glenoid bone loss or capsular deficiency, an isolated arthroscopic Bankart repair will fail. Use the ISIS to flag these patients: a score above 3 pushes you toward a bony procedure.
This paper establishes that the Latarjet can be performed arthroscopically with placement accuracy that beats historical open series, where malposition has run as high as 50%.
The teaching point is the "triple blocking" mental model. Stability comes from three sources: the labral bumper, the coracoid bone block restoring glenoid arc, and the conjoined-tendon belt effect that tensions subscapularis in the throwing position.
Weigh the evidence carefully. This is a Level IV single-surgeon series at only 16 months with a 17% nonunion/migration rate and a steep learning curve requiring staged progression from open to mini-open to arthroscopic. Adding a Bankart to the Latarjet is defensible because isolated Latarjet leaves roughly 30% of patients with persistent apprehension.