Editorial Commentary: The Trillat Procedure May Be (Rarely) Indicated Instead of Shoulder Latarjet for Recurrent Instability, Irreparable Cuff Tear, No Pain, Preserved Active Motion, and No Critical Glenoid Bone Loss.

Abstract

The Latarjet shoulder bone block procedure for recurrent instability has largely replaced the Trillat procedure. Both procedures stabilize the shoulder by a dynamic "sling effect." Latarjet increases the anterior glenoid width or "jumping distance," whereas the Trillat prevents the humeral head anterosuperior migration. The Latarjet violates the subscapularis (albeit to a minimal degree), whereas the Trillat procedure only lowers the subscapularis. One clear indication for the Trillat procedure is recurrent shoulder dislocation associated with functioning irreparable cuff tear in patients with no pain and absence of critical glenoid bone loss. Indications matter.