This is Lafosse's original description of the fully arthroscopic Latarjet procedure for anterior shoulder instability. It is a technique paper, not an outcomes study. It lays out a 5-stage arthroscopic method for transferring the coracoid to the anterior glenoid. The target is instability where Bankart repair alone is likely to fail: glenoid bone loss, ligament insufficiency, HAGL lesions, or failed prior repair.
When you see recurrent anterior instability with glenoid bone loss, an inverted-pear glenoid, an engaging Hill-Sachs, or a failed Bankart, soft-tissue repair alone is likely to fail. This is where a bone-block procedure belongs.
Understand why the Latarjet works, because boards test it. Three effects combine: the coracoid rebuilds the glenoid arc, the conjoined tendon slings across the subscapularis split to reinforce the joint in abduction and external rotation, and the capsule reattaches to the graft.
Read this as a proof-of-concept technique paper. It has no comparative data, no follow-up, and a single-surgeon series of 44 with only preliminary results. Weight it as expert technique description, not evidence of superiority over open Latarjet.
The recurring theme is neurovascular risk: the brachial plexus sits just behind pectoralis minor, so dissection stays close to the coracoid to protect the axillary bundle and musculocutaneous nerve.
This is Lafosse's original description of the fully arthroscopic Latarjet procedure for anterior shoulder instability. It is a technique paper, not an outcomes study. It lays out a 5-stage arthroscopic method for transferring the coracoid to the anterior glenoid. The target is instability where Bankart repair alone is likely to fail: glenoid bone loss, ligament insufficiency, HAGL lesions, or failed prior repair.
When you see recurrent anterior instability with glenoid bone loss, an inverted-pear glenoid, an engaging Hill-Sachs, or a failed Bankart, soft-tissue repair alone is likely to fail. This is where a bone-block procedure belongs.
Understand why the Latarjet works, because boards test it. Three effects combine: the coracoid rebuilds the glenoid arc, the conjoined tendon slings across the subscapularis split to reinforce the joint in abduction and external rotation, and the capsule reattaches to the graft.
Read this as a proof-of-concept technique paper. It has no comparative data, no follow-up, and a single-surgeon series of 44 with only preliminary results. Weight it as expert technique description, not evidence of superiority over open Latarjet.
The recurring theme is neurovascular risk: the brachial plexus sits just behind pectoralis minor, so dissection stays close to the coracoid to protect the axillary bundle and musculocutaneous nerve.