Anthropometric and Radiologic Measurements of Coracoid Dimensions and Clinical Implications in an Indian Population

Joshi, Deepak; Gupta, Lalit; Tanwar, Milind; Lal, Ajay; Chaudhary, Deepak

doi:10.1177/2325967118761635

Cited by 8 publications

(7 citation statements)

References 38 publications

(55 reference statements)

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“…Therefore, in 46% of the cases there was less than the ideal length of 25 mm, according to the original technique [11,15] [19,20]. From the aforementioned studies and the international literature, the coracoid length seems to be positively affected by male gender, age, overall height and Caucasian genetics [12,13,17,20,21]. In our study population, the height of the cadavers was not available, however we observed a positive correlation with the glenoid height.…”

Section: Discussionmentioning

confidence: 59%

Best implant choice for coracoid graft fixation during the Latarjet procedure depends on patients’ morphometric considerations

et al. 2020

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Purpose: To assess the anthropometric dimensions of the coracoid process and the glenoid articular surface and to determine possible implications with the different commercially available Latarjet fixation techniques. Methods: In a total of 101 skeletal scapulae the glenoid length (GL), the glenoid width (GW), the coracoid length (CL), the coracoid width (CW) and the coracoid thickness (CTh) were measured. In order to assess the ability of the transferred coracoid to restore the glenoid anatomy we created a hypothetical model of 10%, 15%, 20%, 25% and 30% glenoid bone loss. We analyzed four common surgical fixation techniques for the Latarjet procedure (4.5 mm screws, 3.75 mm screws, 3.5 mm screws, and 2.8 mm button). The distances from the superior-inferior and mediolateral limits of the coracoid using the four different fixation methods were calculated. We hypothesized that the "safe distance" between the implant and the coracoid osteotomy should be at least equal to the diameter of the implant. Results: The intra and inter-observer reliability tests were almost perfect for all measurements. The mean GH was 36.8 ± 2.5 mm, the GW 26.4 ± 2.2 mm, the CL 23.9 ± 3 mm, the CW 13.6 ± 2.mm, and the mean CTh was 8.7 ± 1.3 mm. The CL was < 25 mm in 46% of the cases. In cases with 25% and 30% bone loss, the coracoid graft restored the glenoid anatomy in 96% and 79.2% of the cases. With the use of the 4.5 mm screws the "safe distance" was present in 56% of the cases, with the 3.75 mm screws in 85%, with the 3.5 mm screws in 87%, and with the 2.8 mm button in 98% of the cases. The distance from the medio-lateral limit of the coracoid could be significantly increased (up to 9 mm) when smaller-button implants are used. Conclusions: The coracoid graft could not always restore glenoid defects of 30%. Larger implants could be positioned too close to the osteotomy and the "medio-lateral offset" of the coracoid could be increased with smaller implants.

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Section: Discussionmentioning

confidence: 59%

Best implant choice for coracoid graft fixation during the Latarjet procedure depends on patients’ morphometric considerations

et al. 2020

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“…Creating a tunnel is suitable for a large coracoid base, such as is generally found in Western populations, 14 , 19 but in East/Southeast Asian populations, this creates a risk of iatrogenic fracture due to the small size of the coracoid base. 6 , 11 For this reason, in East/Southeast Asian populations, most surgeons prefer to loop a suture under the coracoid base rather than creating a coracoid tunnel. The second feature is the clavicle, in which the surgeon can create 1 or 2 clavicular tunnels, with some studies reporting that the double clavicular tunnel method had better clinical and/or radiographic outcomes than the single tunnel method.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Anatomical Landmarks Versus the Coracoid-Based Landmarks Techniques for Coracoclavicular Stabilization After High-Grade Acromioclavicular Injury: A Biomechanical Study

Klabklay

Kwanyuang

Tangjatsakow

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: In acute high-grade acromioclavicular (AC) joint injuries, the aim of treatment is robust reduction and stabilization of the joint. The anatomical landmarks method is most commonly used for stabilization, but loss of reduction often occurs because of the suture tunnels. Purpose/Hypothesis: The purpose was to evaluate and compare the stability of coracoclavicular (CC) stabilization using the anatomical landmarks and coracoid-based landmarks techniques in treating a high-grade AC joint injury. It was hypothesized that stabilization using coracoid-based landmarks would provide better stability. Study Design: Controlled laboratory study. Methods: Twenty fresh-frozen cadaveric shoulders (8 male and 2 female pairs) were randomized into 2 operative technique groups: 10 shoulders in the anatomical landmarks group and 10 shoulders in the coracoid-based landmarks group. The CC ligaments and AC capsule were cut at the midlevel, and CC stabilization and AC capsule repair were performed. For the anatomical landmarks technique, two 2.5-mm clavicular tunnels were created at 25 and 45 mm from the AC joint, while for the coracoid-based landmarks technique, two 2.5-mm clavicular tunnels were drilled using the medial and lateral borders of the coracoid base to choose the tunnel sites. Before injury creation and after stabilization, each shoulder underwent a loading force of 70 N in the superior and anteroposterior directions, and the displacement distance and stiffness were compared between the 2 techniques using the paired t test. Results: The mean difference in displacement before and after stabilization was higher in the anatomical landmarks technique than the coracoid-based landmarks technique (1.82 ± 3.52 vs –0.18 ± 4.78 mm in the superior direction and 7.47 ± 9.35 vs 1.76 ± 3.91 mm in the anteroposterior direction), but none of the differences in displacement or stiffness were statistically significant between the groups. Conclusion: No significant biomechanical differences in displacement or stiffness were seen between the anatomical landmarks technique and the coracoid-based landmarks technique. Clinical Relevance: Either stabilization technique can be utilized for repair of the CC ligaments in an acute AC injury setting.

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“…These cutoffs were selected as the whole numbers nearest the means of coracoid length and width in this patient cohort, with several CT studies finding a mean coracoid length between 21 and 24 mm. 14 , 16 , 19 Demographic and postoperative outcomes were compared between shorter and longer coracoids, narrower and wider coracoids, and male and female coracoid dimensions. Independent-samples t tests were utilized to calculate P values for parametric data, and Mann-Whitney tests were used to calculate P values for nonparametric data.…”

Section: Methodsmentioning

confidence: 99%

Effect of Preoperative MRI Coracoid Dimensions on Postoperative Outcomes of Latarjet Treatment for Anterior Shoulder Instability

Paul

DeBernardis

Hameed

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Preoperative coracoid dimensions may affect the size of the bone graft transferred to the glenoid rim and thus the postoperative outcomes of Latarjet coracoid transfer. Purpose: To determine the effect of coracoid length and width as measured on preoperative magnetic resonance imaging (MRI) on outcomes after Latarjet treatment of anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Included were patients who underwent primary Latarjet surgery between 2009 and 2019 and had preoperative MRI scans and minimum 2-year postoperative outcomes. Longitudinal coracoid length was measured on axial MRI sequences as the distance from the coracoclavicular ligament insertion to the distal tip. Comparisons were made between shorter and longer coracoids and between narrower and wider coracoids. The outcomes of interest were recurrent instability, reoperation, complications, return to sport (RTS), and American Shoulder and Elbow Surgeons (ASES) score. Independent-samples t test, Mann-Whitney test, chi-square test, and Fisher exact test were used to compare outcomes between groups, and univariate correlation coefficients were calculated to evaluate the relationships between demographics and coracoid dimensions. Results: Overall, 56 patients were included (mean age, 28.4 years). The mean ± SD coracoid length was 21.6 ± 2.4 mm and width 10.0 ± 1.0 mm. Relative to patients with a longer coracoid (≥22 mm; n = 26), patients with a shorter coracoid (<22 mm; n = 30) had similar rates of recurrent instability (shorter vs longer; 6.7% vs 3.8%), complications (10.0% vs 15.4%), reoperation (3.3% vs 7.7%), and RTS (76.5% vs 58.8%) and similar postoperative ASES scores (85.0 vs 81.6) ( P ≥ .05 for all). Likewise, relative to patients with a wider coracoid (≥10 mm; n = 27), patients with a narrower coracoid (<10 mm; n = 29) had similar prevalences of recurrent instability (narrower vs wider; 6.9% vs 3.7%), complications (17.2% vs 7.4%), reoperation (3.5% vs 7.4%), and RTS (66.7% vs 68.4%) and similar postoperative ASES scores (87.1 vs 80.0) ( P ≥ .05 for all). Conclusion: Patients undergoing Latarjet coracoid transfer had similar postoperative outcomes regardless of preoperative coracoid dimensions. These findings should be confirmed in a larger cohort before further clinical recommendations are made.

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Anthropometric and Radiologic Measurements of Coracoid Dimensions and Clinical Implications in an Indian Population

Cited by 8 publications

References 38 publications

Best implant choice for coracoid graft fixation during the Latarjet procedure depends on patients’ morphometric considerations

Best implant choice for coracoid graft fixation during the Latarjet procedure depends on patients’ morphometric considerations

Comparing the Anatomical Landmarks Versus the Coracoid-Based Landmarks Techniques for Coracoclavicular Stabilization After High-Grade Acromioclavicular Injury: A Biomechanical Study

Effect of Preoperative MRI Coracoid Dimensions on Postoperative Outcomes of Latarjet Treatment for Anterior Shoulder Instability

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