A bicentric Level I RCT comparing two bone-grafting options for anterior shoulder instability with glenoid bone loss of at least 15%. Sixty patients were randomized to open Latarjet (coracoid transfer) or open iliac crest bone graft transfer (J-bone graft). The study asked whether one technique produces better clinical and radiologic outcomes at 2 years.
When you have a young patient with recurrent anterior instability and at least 15% glenoid bone loss, soft-tissue Bankart repair fails too often, so a bony procedure is indicated. This trial tells you that Latarjet and iliac crest bone graft give equivalent stability and patient-reported outcomes at 2 years, so the choice comes down to the complication profile each patient can best tolerate.
Latarjet predictably costs internal rotation (2 to 3 vertebral levels) from the permanent subscapularis split traversed by the conjoined tendon. Counsel overhead and behind-the-back-reach patients accordingly. ICBGT avoids the shoulder hardware issues but trades them for iliac crest donor-site morbidity, with roughly one in four patients reporting sensory disturbance.
For boards, anchor the workup in 3D CT with the Pico method for glenoid loss and the on-track/off-track glenoid track concept for bipolar bone loss.
A bicentric Level I RCT comparing two bone-grafting options for anterior shoulder instability with glenoid bone loss of at least 15%. Sixty patients were randomized to open Latarjet (coracoid transfer) or open iliac crest bone graft transfer (J-bone graft). The study asked whether one technique produces better clinical and radiologic outcomes at 2 years.
When you have a young patient with recurrent anterior instability and at least 15% glenoid bone loss, soft-tissue Bankart repair fails too often, so a bony procedure is indicated. This trial tells you that Latarjet and iliac crest bone graft give equivalent stability and patient-reported outcomes at 2 years, so the choice comes down to the complication profile each patient can best tolerate.
Latarjet predictably costs internal rotation (2 to 3 vertebral levels) from the permanent subscapularis split traversed by the conjoined tendon. Counsel overhead and behind-the-back-reach patients accordingly. ICBGT avoids the shoulder hardware issues but trades them for iliac crest donor-site morbidity, with roughly one in four patients reporting sensory disturbance.
For boards, anchor the workup in 3D CT with the Pico method for glenoid loss and the on-track/off-track glenoid track concept for bipolar bone loss.