JSES - 2026-05-12 - Journal Article
Pectoralis Minor Reattachment in Latarjet Procedure: Improvement of Scapular Stability in High-Performance Contact Athletes- Retrospective Cohort Comparison.
Gustavo Armando TA, José Rene CG, Verónica Itzel VS, José Manuel SJ, Carlos Omar SC, Jaime BR
Topics
Key Takeaway
Pectoralis minor reattachment during Latarjet reduced positive scapular dyskinesis test rates across all five assessment tools (OR 0.007–0.095) and improved UCLA scores by 5 points (34 vs. 29) in high-performance contact athletes.
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Summary
This retrospective case-control study asked whether pectoralis minor reattachment during Latarjet reduces scapular dyskinesis and improves function in high-performance contact athletes with recurrent anterior instability and glenoid bone loss. Nineteen athletes with reattachment were compared to 19 without, using five validated scapular dyskinesis tests, ROM, and UCLA scores at minimum 24-month follow-up. Reattachment was associated with significantly lower odds of positive dyskinesis on all five tests (OR 0.007–0.095, all adjusted P ≤ .002), 19° greater ER at 90° abduction, and 5-point higher UCLA scores—both exceeding published MCIDs.
Key Limitation
The retrospective non-randomized design with only 19 patients per group cannot exclude selection bias, as surgeons may have preferentially reattached pectoralis minor in athletes with better tissue quality or lower preoperative dyskinesis burden.
Original Abstract
BACKGROUND
The Latarjet procedure is effective for recurrent anterior shoulder instability with glenoid bone loss; however, as a non-anatomic technique, it may lead to scapular dyskinesis, particularly in contact athletes. The necessity of reattaching the pectoralis minor remains a subject of debate. We hypothesized that pectoralis minor reattachment during the Latarjet procedure would be associated with a lower incidence of scapular dyskinesis and improved functional outcomes in high-performance contact athletes.
METHODS
A retrospective, assessor-blinded, case-control study was conducted on 38 high-performance contact athletes with recurrent anterior shoulder instability and glenoid bone loss who underwent the Latarjet procedure between January 2020 and December 2023. Patients were divided into two equal groups (n = 19): an intervention group (with pectoralis minor reattachment) and a control group (without reattachment). With a minimum follow-up of 24 months, outcomes were evaluated using range of motion, the UCLA shoulder rating scale, and five scapular dyskinesis tests: Scapular Dyskinesis Test (SDT), Lateral Scapular Slide Test (LSST) at 30 degrees and 90 degrees, Scapular Reposition Test (SRT), and Scapular Assistance Test (SAT). The Benjamini-Hochberg correction was applied to account for multiple comparisons.
RESULTS
Logistic regression analysis demonstrated that pectoralis minor reattachment was associated with a significant reduction in positive dyskinesis tests across all five assessment tools, with odds ratios ranging from 0.007 to 0.095 (all adjusted P ≤ .002 after correction). External rotation at 90 degrees of abduction was significantly higher in the intervention group (105 degrees vs. 86 degrees, P < .001), exceeding the minimal clinically important difference (MCID) of 10 degrees. UCLA scores were higher in the intervention group (34 vs. 29 points, P < .001), exceeding the MCID of 3 points.
CONCLUSION
Pectoralis minor reattachment during the Latarjet procedure is associated with a lower prevalence of scapular dyskinesis and improved functional outcomes in high-performance contact athletes. A prospective randomized trial is warranted to determine if these associations are causally related to pectoralis minor repair.