Background – Despite the clinical relevance of forearm fractures and malunions and the impact of a functional limitation, the link between forearm malalignment and limited pronation and supination remains poorly understood and still relies on anatomical alignment expressed as angulation. Using recently developed technologies, mechanisms that limit function can be automatically detected by modeling individual forearm kinematics using three-dimensional (3D) bone models of the radius and ulna.Questions/purposes – We evaluated the accuracy of a personalized 3D kinematic model to identify limitations in forearm rotation in pronation and supination and to answer the following questions: (1) How accurately does the model-predicted ROM agree with the corresponding clinical measurements? (2) How accurately does the model classify malunited forearms according to the presence of clinically relevant functional limitations, defined as a range of pronation or supination less than 50°? (3) What is the frequency at which the model detects bone impingement and central band block during pronation and supination?Methods – This retrospective study evaluated a diagnostic model using the preoperative CT scans of 45 patients with unilateral diaphyseal forearm malunions, all of whom underwent corrective osteotomy due to a clinically relevant limitation in pronation or supination function. In all, 53% (24) of patients were male; the mean ± SD age at the time of the CT scan was 16 ± 6 years, and the mean time since the original trauma was 6 ± 5 years. Twenty patients had a clinically relevant loss of pronation, 15 patients had a loss of supination, and 10 patients had a loss of both. We generated 3D bone models with landmarks to simulate forearm rotation in 5° steps from 100° of pronation to 100° of supination. Two mechanisms that limit function after diaphyseal malunions—bone impingement and central band blockage—were identified in the simulation, resulting in a predicted ROM. For the first study question, differences between clinical and predicted function were expressed as mean absolute error, root mean square error, and mean error to illustrate typical error size, penalize outliers, and quantify the direction of error deviation, respectively. Acceptable errors were around 15°, comparable to the range seen in clinical measurements. For question two, clinical measurements and predictions were dichotomized based on a threshold of 50°. Accuracy, sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic (ROC) curve for detecting clinically relevant limitations were calculated separately for pronation and supination. Acceptable diagnostic values should be above 60%, which is normal for angulation measurements. For question three, the blocking mechanisms detected during the simulation were counted.Results – Mean absolute errors between prediction and clinical measurement for pronation, supination, and ROM were 19°, 23°, and 22°, respectively. Root mean square errors were 22° for pronation, 28° for supination, and 28° for ROM. Mean errors were 3° for pronation, 1° for supination, and 5° for ROM. Errors were substantially higher than the clinical measurement uncertainty, with some outliers. Accuracy for finding a relevant pronation or supination limitation was 91% and 82%, respectively. Diagnostic values for detecting pronation limitations were 91% for accuracy, 87% for sensitivity, 100% for specificity, 79% for negative predictive value, and 100% for positive predictive value. For supination, the values were 82% for accuracy, 84% for sensitivity, 80% for specificity, 80% for negative predictive value, and 84% for positive predictive value. Area under the curve values were 0.97 (95% confidence interval [CI] 0.93 to 1) for detecting pronation limitations and 0.93 (95% CI 0.87 to 1) for supination limitations. These values are higher than those reported by studies using angulation thresholds. Bone impingement was mainly seen during pronation, and a central band block was the most common reason for a supination limitation.Conclusion – Individualized kinematic modeling of forearm malunions reliably detects clinically relevant limitations of forearm rotation without requiring dynamic imaging. Because of simplifications on the exact location and status of the central band and the neutral position of the forearm, exact ROM prediction is not possibleClinical Relevance – This study represents an important step toward functional rather than anatomical evaluation of forearm anatomy and correction of malunited forearm fractures. The next step would be to use the model in preoperative planning optimization, focusing on functional outcomes rather than purely anatomical correction. Given the model’s high diagnostic accuracy, personalized 3D kinematic modeling has potential as a decision tool for determining whether a forearm fracture should undergo operative treatment or whether it can be managed nonoperatively. However, challenges regarding fracture remodeling and stability in a cast, along with low-dose 3D imaging, must be addressed.

Manual wheelchair users experience significant upper extremity strain, leading to a high prevalence of shoulder pain. Identifying modifiable risk factors for shoulder complaints is crucial for developing effective interventions. Consequently, it's important to quantify shoulder load (magnitude, frequency and duration) experienced by manual wheelchair users throughout the day. This study aims to quantify the magnitude of shoulder load during various daily activities, including wheelchair propulsion at different speeds and inclines, ascending and descending ramps, weight relief lift, material handling and desk work. Ten able-bodied participants performed these activities while their upper extremity kinematics and exerted forces were measured. The analysis focused on glenohumeral contact force and rotator cuff muscle forces using the Delft Shoulder and Elbow Model. Highest mean glenohumeral contact forces were found during weight relief lift (1363 ± 1204 N), followed by descending a ramp (997 ± 1043 N) and fast propulsion (802 ± 742 N). The supraspinatus muscle generated the greatest force during weight relief lift (327 ± 490 N) and fast propulsion (184 ± 205 N). These findings provide a first reference for estimating joint load in daily activities. By combining these data with the individual activity frequency and duration, personalized shoulder load exposure can be assessed, informing the development of targeted interventions to reduce shoulder pain in manual wheelchair users.

Musculoskeletal (MSK) models offer a non-invasive way to understand biomechanical loads on joints and tendons, which are difficult to measure directly. Variations in muscle strength, especially relative differences between muscles, significantly impact model outcomes. Typically, scaled generic MSK models use maximum isometric forces that are not adjusted for different demographics, raising concerns about their accuracy. This review provides an overview on experimentally derived strength parameters, including physiological cross-sectional area (PCSA), muscle mass (Mm), and relative muscle mass (%Mm), which is the relative distribution of muscle mass across the leg. Limited lower extremity PCSA data prevented assessment of differences in PCSA distribution. We analysed differences by age and sex, and compared open-source lower limb MSK model parameters with experimental data from 57 studies. Our dataset, with records dating back to 1884, shows that uniformly increasing all maximum isometric forces in MSK models does not capture key age-and sex-related differences in muscle ratio. Males have a significantly higher proportion of muscle mass in the rectus femoris(12%) and semimembranosus(15%) muscles, while females have a greater relative muscle mass in the pelvic (gluteus maximus(17%) and medius(23%)) and ankle muscles (tibialis anterior(14%) and posterior(15%), and extensor digitorum longus(16%)). Older adults have a higher relative muscle mass in the gluteus medius(37%), while younger individuals show more in the gastrocnemius(31%). Current MSK models do not accurately represent muscle mass distribution for specific age or sex groups. None of them accurately reflect female muscle mass distribution. Further research is needed to explore musculotendon age- and sex differences.

Shoulder problems are highly prevalent among manual wheelchair users with spinal cord injury, affecting their functioning and quality of life. This study investigates the impact of fatigue on wheelchair propulsion technique and shoulder loading in manual wheelchair users (MWU) with SCI. Twelve MWU with a paraplegia performed a standardized fatiguing wheelchair propulsion protocol; a biomechanical assessment of treadmill propulsion was obtained before and after the fatiguing protocol. Rate of perceived exertion (RPE), upper extremity kinematics, and wheelchair propulsion kinetics were assessed. Results showed increased RPE post-fatigue, with no significant changes in exerted forces but increased thorax forward lean and range of motion. Musculoskeletal modelling showed elevated glenohumeral joint contact force and muscle forces post-fatigue. These findings suggest a potential link between fatigue, altered propulsion technique, and increased shoulder loading, highlighting the risk of overuse injuries. Moreover, increased thorax motion during propulsion may indicate fatigue onset. Prospective cohort studies are warranted to validate the presented findings and explore the relationship between shoulder loading and injury risk. Understanding these dynamics can inform interventions to mitigate shoulder pain and enhance the well-being of MWU with SCI.

Background: Dynamic medical imaging can determine the cause of rotational impairment in the forearm. However, it has drawbacks depending on the image modality used, related to radiation dose, the need for specialized equipment, and the labor intensity involved in the analysis. Because the forearm rotation axis is static, we hypothesize that an axis based on bony landmarks is comparable to an axis calculated from dynamic imaging. Methods: Eight post-mortem human forearms were scanned using CT in seven rotational positions from maximum supination to maximum pronation. Three rotation axes were calculated: the landmark, average helical, and circle fit axes. The primary outcome is the difference between the axes expressed as the angle and the minimal distance between them. Secondary outcomes are the orientation errors when modeling pose using the three found axes. Findings: The mean difference between the landmark and average helical axes was 0.38 degrees and 0.51 mm. The mean difference between the landmark and circle fit axes was 0.40 degrees and 0.51 mm. When modeling the pose of the radius using one of the three axes, the difference between the modeled radius and the scanned radius was in each direction below 2 mm and 1 degree. Interpretation: The rotation axis of the forearm can be accurately calculated using automatically placed bony landmarks. These findings indicate that determining the forearm rotation axis does not require multiple static images or dynamic imaging. This knowledge should be applied to clinical data to assess its applicability in practice.

Objective: Analyzing population trends of bone shape variation can provide valuable insights into growth processes. This review aims to overview state-of-the-art spatiotemporal statistical shape modeling techniques, emphasizing their application to 3D skeletal structures during healthy growth. Methods: We searched PubMed and Scopus for articles on statistical shape modeling using a pediatric spatiotemporal dataset of 3D healthy bone models. Dataset characteristics and details on the shape models' development, analyses, and potential clinical use were extracted. Results: Fourteen studies were found eligible, modeling one or multiple lower limb bones, the mandible, the skull, and vertebrae. The majority applied Principal Component Analysis on point distribution models to create a statistical shape model. Shape variation was analyzed based on shape modes, representing a specific shape change as a part of the overall variance. Unscaled models resulted in a more compact statistical shape model than scaled models. The latter represented more subtle shape variations due to the absence of size differences between the bone models. Four studies reported a significant correlation between the first shape mode and age, indicating a relationship between that type of shape variation and growth. Three studies reconstructed 3D models using prediction features of statistical shape modeling. Measuring difference between predicted and actual anatomy resulted in Root Mean Squared Errors below 3 mm. Conclusion: Spatiotemporal statistical shape modeling provides insight into modes of shape variation during growth. Such a model can be used to find predictive factors, like age or sex, and deploy these characteristics to predict someone's bone geometry.

Background: In baseball, repetitive pitching leads to medial elbow injuries, particularly to the ulnar collateral ligament (UCL). To prevent pitchers from UCL injuries, it is important to quantify the response to elbow stress. Repetitive elbow external valgus torque and muscular fatigue induced by repetitive pitching could affect markers of the response, that is, humeroulnar joint gap and UCL morphology. The aims of the study were three-folded: to investigate the effect of (1) exerted handgrip force on the humeroulnar joint gap, (2) repetitive pitching on the humeroulnar joint gap and the UCL morphology, and (3) exerted handgrip force on the humeroulnar joint gap for different levels of elbow valgus stress is different after compared to before repetitive pitching in asymptomatic baseball pitchers. Methods: Medial elbow ultrasound images were collected in 15 asymptomatic male baseball pitchers. Three levels of static elbow valgus stress (0N, 50N, 100N) were applied with a TELOS device before and after repetitive pitching and with or without handgrip force. These images were used to assess the humeroulnar joint gap size and UCL length and thickness. After 110 fastball pitches or when 80% self-perceived fatigue on a VAS scale was reached, participants were instructed to stop throwing. Repeated measures ANOVAs were used to statistically test significant differences. Results: Handgrip force did not significantly affect the humeroulnar joint gap. The UCL thickness and length and the humeroulnar joint gap were also not different after compared to before repetitive pitching. While higher levels of applied valgus stress significantly increased the humeroulnar joint gap (P < .001), this effect was not significantly different in the interaction with handgrip force and repetitive pitching. Conclusion: The humeroulnar joint gap changes for different levels of elbow valgus stress. However, adult baseball pitchers did not respond to elbow stress after a single pitching session with or without submaximal handgrip force in the humeroulnar joint gap and UCL morphology.

CONTEXT: Baseball pitching requires fast and coordinated motions of the whole body to reach high ball speeds, putting considerable strain on the musculoskeletal system, particularly the shoulder and elbow. OBJECTIVE: To describe musculoskeletal symptoms and the functional status of the shoulder and elbow in male high school baseball pitchers. DESIGN: Descriptive epidemiology study. SETTING: Dutch baseball talent academies. PATIENTS OR OTHER PARTICIPANTS: One hundred twenty-five male high school baseball pitchers aged 12 to 18 years who participated in 1 of the 6 Dutch baseball talent academies and the Dutch National U-18 team were recruited and enrolled. MAIN OUTCOME MEASURE(S): Musculoskeletal symptoms, functional status of the shoulder and elbow were registered for each player every 6 months over 2 consecutive baseball seasons through self-assessment questionnaires, including the Kerlan-Jobe Orthopaedic Clinic (KJOC) and the Western Ontario Shoulder Instability Index (WOSI) questionnaires. RESULTS: Five hundred seventy musculoskeletal (MSS) symptoms in 93 of the 125 players were reported. The average 6-month prevalence for symptoms of the throwing shoulder was 37% (95% CI = 33%-41%), and for the elbow 37% (95% CI = 31%-42%), followed by the lower back with 36% (95% CI = 26%-45%). The baseball pitchers who experienced only shoulder symptoms had an average KJOC score of 80.0 (95% CI = 75.3-84.7) points, whereas those with only elbow symptoms reported a score of 90.2 (95% CI = 89.2-95.3). On the WOSI questionnaire, baseball pitchers scored an average of 421.2 (95% CI = 200.1-642.4) points. CONCLUSIONS: In a cohort of Dutch high school baseball pitchers, one-third reported shoulder and elbow symptoms on the throwing side, with reduced functional status and lower back symptoms. Future efforts should focus on developing preventive strategies through early symptom detection, aiming to prevent symptom progression and, ultimately, the development of severe injuries.

The baseball pitch is a repetitive, full-body throwing motion that exposes the elbow to significant loads, leading to a high incidence of elbow injuries. Elbow injuries in pitching are often attributed to high external valgus torques as these are generally considered to be a good proxy for the load on the Ulnar Collateral Ligament. The aim of the study is to contribute to elbow load monitoring by developing a prediction model based on the pelvis and trunk peak angular velocities and their separation time. Eleven male youth elite baseball pitchers (age 17 ± 2.2 years) threw 25 fastballs at full effort off a mound. Two-level varying-intercept, varying-slope Bayesian models were used to predict external valgus torque based on (inter)segmental rotation in fastball pitching with pitcher’s weight and height added to strengthen the individualisation of the prediction. The results revealed the high predictive performance of the models including a set of kinematic parameters trunk peak angular velocity and the separation time between the pelvis and trunk peak angular velocities. Such an approach allows individualised prediction of the external valgus torque for each pitcher, which has a great practical advantage compared to group-based predictions in terms of injury assessment and injury prevention.

This multicenter observational study aimed to assess how pain reduction, induced by local anesthesia, affects the relative angular contributions of the shoulder girdle and trunk to the maximal angular performance during a semi-constrained overhead reach task in patients with ongoing shoulder pain. Twenty-nine individuals (age 59.0 SD 12.8 years;16-male) with symptomatic shoulders were administered corticosteroid and lidocaine injections by their attending orthopedic surgeon. Immediately before and after the injections, participants reached for a target on the ceiling ten times as high as possible while their pain levels, shoulder, and trunk movements were recorded. The analysis revealed that there was a significant reduction in pain following the injections. However, there were no significant differences in maximum shoulder and trunk inclination angles between the pre- and post-injection conditions. Notably, there were slight but statistically significant alterations in humeroscapular kinematics during the initial phase of arm elevation following the injections. In conclusion, acute pain relief following local anesthetics is not associated with immediate alterations in maximum shoulder girdle and trunk inclination angles during a semi-constrained overhead reach task in patients with ongoing shoulder pain. However, there are signs of small alterations in humeroscapular kinematics during the initial phase of arm elevation.

An important performance determinant in wheelchair sports is the power exchanged between the athlete-wheelchair combination and the environment, in short, mechanical power. Inertial measurement units (IMUs) might be used to estimate the exchanged mechanical power during wheelchair sports practice. However, to validly apply IMUs for mechanical power assessment in wheelchair sports, a well-founded and unambiguous theoretical framework is required that follows the dynamics of manual wheelchair propulsion. Therefore, this research has two goals. First, to present a theoretical framework that supports the use of IMUs to estimate power output via power balance equations. Second, to demonstrate the use of the IMU-based power estimates during wheelchair propulsion based on experimental data. Mechanical power during straight-line wheelchair propulsion on a treadmill was estimated using a wheel mounted IMU and was subsequently compared to optical motion capture data serving as a reference. IMU-based power was calculated from rolling resistance (estimated from drag tests) and change in kinetic energy (estimated using wheelchair velocity and wheelchair acceleration). The results reveal no significant difference between reference power values and the proposed IMU-based power (1.8% mean difference, N.S.). As the estimated rolling resistance shows a 0.9–1.7% underestimation, over time, IMU-based power will be slightly underestimated as well. To conclude, the theoretical framework and the resulting IMU model seems to provide acceptable estimates of mechanical power during straight-line wheelchair propulsion in wheelchair (sports) practice, and it is an important first step towards feasible power estimations in all wheelchair sports situations.

Paralympic wheelchair athletes solely depend on the power of their upper-body for their on- court wheeled mobility as well as for performing sport-specific actions in ball sports, like a basketball shot or a tennis serve. The objective of WheelPower is to improve the power output of athletes in their sport-specific wheelchair to perform better in competition. To achieve this objective the current project systematically combines the three Dutch measurement innovations (WMPM, Esseda wheelchair ergometer, PitchPerfect system) to monitor a large population of athletes from different wheelchair sports resulting in optimal power production by wheelchair athletes during competition. The data will be directly implemented in feedback tools accessible to athletes, trainers and coaches which gives them the unique opportunity to adapt their training and wheelchair settings for optimal performance. Hence, the current consortium facilitates mass and focus by uniting scientists and all major Paralympic wheelchair sports to monitor the power output of many wheelchair athletes under field and lab conditions, which will be assisted by the best data science approach to this challenge.

In wheelchair sports, there is an increasing need to monitor mechanical power in the field. When rolling resistance is known, inertial measurement units (IMUs) can be used to determine mechanical power. However, upper body (i.e., trunk) motion affects the mass distribution between the small front and large rear wheels, thus affecting rolling resistance. Therefore, drag tests – which are commonly used to estimate rolling resistance – may not be valid. The aim of this study was to investigate the influence of trunk motion on mechanical power estimates in hand-rim wheelchair propulsion by comparing instantaneous resistance-based power loss with drag test-based power loss. Experiments were performed with no, moderate and full trunk motion during wheelchair propulsion. During these experiments, power loss was determined based on 1) the instantaneous rolling resistance and 2) based on the rolling resistance determined from drag tests (thus neglecting the effects of trunk motion). Results showed that power loss values of the two methods were similar when no trunk motion was present (mean difference [MD] of 0.6 ± 1.6 %). However, drag test-based power loss was underestimated up to −3.3 ± 2.3 % MD when the extent of trunk motion increased (r = 0.85). To conclude, during wheelchair propulsion with active trunk motion, neglecting the effects of trunk motion leads to an underestimated mechanical power of 1 to 6 % when it is estimated with drag test values. Depending on the required accuracy and the amount of trunk motion in the target group, the influence of trunk motion on power estimates should be corrected for.

Background: For bone morphology and biomechanics analysis, landmarks are essential to define position, orientation, and shape. These landmarks define bone and joint coordinate systems and are widely used in these research fields. Currently, no method is known for automatically identifying landmarks on virtual 3D bone models of the radius and ulna. This paper proposes a knowledge-based method for locating landmarks and calculating a coordinate system for the radius, ulna, and combined forearm bones, which is essential for measuring forearm function. This method does not rely on pre-labeled data. Validation: The algorithm is validated by comparing the landmarks placed by the algorithm with the mean position of landmarks placed by a group of experts on cadaveric specimens regarding distance and orientation. Results: The median Euclidean distance differences between all the automated and reference landmarks range from 0.4 to 1.8 millimeters. The median angular differences of the coordinate system of the radius and ulna range from -1.4 to 0.6 degrees. The forearm coordinate system's median errors range from -0.2 to 2.0 degrees. The median error in calculating the rotational position of the radius relative to the ulna is 1.8 degrees. Conclusion: The automatic method's applicability depends on the use context and desired accuracy. However, the current method is a validated first step in the automatic analysis of the three-dimensional forearm anatomy.

Accurate assessment of rolling resistance is important for wheelchair propulsion analyses. However, the commonly used drag and deceleration tests are reported to underestimate rolling resistance up to 6% due to the (neglected) influence of trunk motion. The first aim of this study was to investigate the accuracy of using trunk and wheelchair kinematics to predict the intra-cyclical load distribution, more particularly front wheel loading, during hand-rim wheelchair propulsion. Secondly, the study compared the accuracy of rolling resistance determined from the predicted load distribution with the accuracy of drag test-based rolling resistance. Twenty-five able-bodied participants performed hand-rim wheelchair propulsion on a large motor-driven treadmill. During the treadmill sessions, front wheel load was assessed with load pins to determine the load distribution between the front and rear wheels. Accordingly, a machine learning model was trained to predict front wheel load from kinematic data. Based on two inertial sensors (attached to the trunk and wheelchair) and the machine learning model, front wheel load was predicted with a mean absolute error (MAE) of 3.8% (or 1.8 kg). Rolling resistance determined from the predicted load distribution (MAE: 0.9%, mean error (ME): 0.1%) was more accurate than drag test-based rolling resistance (MAE: 2.5%, ME: −1.3%).

Humans possess an incredible capacity for dexterity, but independent finger control is limited. One factor constraining finger independence is the connections between the tendons of the extrinsic finger muscles. The aim of this study was to assess to what extent the linkages between the distal tendons of flexor digitorum profundus (FDP) and those of the flexor digitorum superficialis (FDS) constrain finger independence. Experiments on human fresh frozen cadaveric upper extremities (n = 6) were performed. First, one finger (target) was flexed whereas the other (nontarget) fingers were held in a nearly extended position. The change (Δ) in total flexion angle (∑Θ; i.e., the sum of angles of the different finger joints) of the target finger from the ∑Θ corresponding to the extended position at the start of the movement until the ∑Θ corresponding to the onset of force exertion at the nontarget fingers was assessed. Second, the distribution of force across the four fingers upon loading the tendon of the target finger was assessed for two finger positions (extended, 90° flexion of metacarpal phalangeal joint). For both muscles and for all fingers, the range of independent movement was small (<7°). Δ∑Θ at force onset was lowest for fingers immediately adjacent to the target finger and highest for more distant fingers. For both muscles and for all fingers, some of the target finger force (<14% for FDP, <2% for FDS) was distributed to the nontarget fingers, which increased (up to 58%) only for FDP in response to target finger flexion. We conclude that mechanical connections between the FDP and FDS tendons constrain finger independence. Such constraints become apparent when moving one finger relative to the other fingers.

Up to 60% of patients experience recurrence after a first traumatic anterior shoulder dislocation (FTASD), which is often defined as having experienced either dislocation or subluxation. Thus surgical intervention after FTASD is worthy of consideration and is guided by the number of patients who need to receive surgical intervention to prevent 1 redislocation (i.e., number needed to treat), (subjective) health benefit, complication risk, and costs. Operative intervention through arthroscopic stabilization can be successful in reducing recurrence risk in FTASD, as has been shown in multiple randomized controlled trials. Nevertheless, there is a large “gray area” for the indication of arthroscopic stabilization, and it is therefore heavily debated which patients should receive operative treatment. Previous trials showed widely varying redislocation rates in both the intervention and control group, meta-analysis shows 2% to 19% after operative and 20% to 75% after nonoperative treatment, and redislocation rates may not correlate with patient-reported outcomes. The literature is quite heterogeneous, and a major confounder is time to follow-up. Furthermore, there is insufficient standardization of reporting of outcomes and no consensus on definition of risk factors. As a result, surgery is a reasonable intervention for FTASD patients, but in which patients it best prevents redislocation requires additional refinement.

Purpose: To evaluate the current literature on the effects of anatomic changes caused by the Latarjet procedure and to identify areas for future research. Methods: English-language studies that addressed the consequences of anatomic alterations after the open Latarjet procedure were included. Articles written in languages other than English, reviews, and case reports were excluded. Titles and abstracts were screened by 2 authors. Studies that met the inclusion criteria were screened by the same authors. The following data were extracted from the included studies: authors, year of publication, journal, country of origin, aims or purpose, study population and sample size, methods, procedure, intervention type, and key findings that relate to the scoping review questions. Results: Twenty-two studies were included for analysis, yielding the following findings: First, the Latarjet procedure may change the position of the scapula owing to pectoralis minor tenotomy and/or transfer of the conjoint tendon. Second, dissection of the coracoacromial ligament may result in increased superior translation of the humeral head. The impact of this increased translation on patients’ function remains unclear. Third, the subscapularis split shows, overall, better internal rotation strength compared with subscapularis tenotomy. Fourth, passive external rotation may be limited after capsular repair. Fifth, despite the movement of the conjoint tendon, elbow function seems unchanged. Finally, the musculocutaneous nerve is lengthened with a changed penetration angle into the coracobrachialis muscle, but the clinical impact seems limited. Conclusions: The Latarjet procedure leads to anatomic and biomechanical changes in the shoulder. Areas of future research may include better documentation of scapular movement (bilateral, as well as preoperative and postoperative) and elbow function, the effect of (degenerative) rotator cuff ruptures after the Latarjet procedure on shoulder function, and the impact of capsular closure and its contribution to the development of glenohumeral osteoarthritis. Clinical Relevance: This comprehensive overview of anatomic changes after the Latarjet procedure, with its effects on shoulder and elbow function, showed gaps in the current literature. Orthopaedic shoulder surgeons and physical therapists could use our findings when providing patient information and performing future clinical research.