The latarjet procedure for recurrent anterior shoulder instability: Rationale and technique

Posterosuperior glenoid impingement (PSGI) is defined as mechanical impingement of the greater tuberosity onthe posterosuperior aspect of the glenoid rim during shoulder abduction, external rotation, and extension. Although this contact is present in most of the population, throwing athletes are particularly vulnerable to developing symptoms related to this impingement, predominantly from partial thickness tears of the rotator cuff. It has been suggested that subtle or “micro”-instability is the underlying source of this “internal” impingement. After examining these claims with regard to our experience and experience of others, this does not seem to be the case. Additionally, we report our preferred treatment regimen for PSGI including our technique for humeral derotational osteotomy.