Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

Giacomo, Giovanni Di; Costantini, Alberto; Gasperis, Nicola de; Vita, Andrea De; Lin, Bernard K.H.; Francone, Marco; Beccaglia, Mario A. Rojas; Mastantuono, M.

doi:10.4103/0973-6042.109877

Cited by 42 publications

(36 citation statements)

References 17 publications

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“…ey suggested that if predicted glenoid track remained offtrack with a classically performed Latarjet, a congruent arc might prove beneficial with its larger surface area. Others have said, however, that larger grafts than necessary will see higher rates of graft osteolysis, as less forces from the humeral head are applied leading to resorption in accordance with Wolff's law [45]. In this study, our results show that there is no statistically significant difference in the force required to produce an anteroinferior dislocation of the shoulder after either classical or congruent arc Latarjet. is suggests that both techniques will provide adequate bony coverage to an anterior glenoid defect and will be effective in preventing recurrent dislocation.…”

Section: Discussionsupporting

confidence: 41%

A Biomechanical Comparison of Two Techniques of Latarjet Procedure in Cadaveric Shoulders

Prinja

Raymond

Pimple

2020

Advances in Orthopedics

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Traumatic anterior instability of the shoulder is commonly treated with the Latarjet procedure, which involves transfer of the coracoid process with a conjoint tendon to the anterior aspect of the glenoid. The two most common techniques of the Latarjet are the classical and congruent arc techniques. The aim of this study was to evaluate the difference in force required to dislocate the shoulder after classical and congruent arc Latarjet procedures were performed. Fourteen cadaveric shoulders were dissected and osteotomised to produce a bony Bankart lesion of 25% of the articular surface leading to an “inverted pear-shaped” glenoid. An anteroinferior force was applied whilst the arm was in abduction and external rotation using a pulley system. The force needed to dislocate was noted, and then the shoulders underwent coracoid transfer with the classical and congruent arc techniques. The average force required to dislocate the shoulder after osteotomy was 123.57 N. After classical Latarjet, the average force required was 325.71 N, compared with 327.14 N after the congruent arc technique. This was not statistically significant. In this biomechanical cadaveric study, there is no difference in the force required to dislocate a shoulder after classical and congruent arc techniques of Latarjet, suggesting that both methods are equally effective at preventing anterior dislocation in the position of abduction and external rotation.

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Section: Discussionsupporting

confidence: 41%

A Biomechanical Comparison of Two Techniques of Latarjet Procedure in Cadaveric Shoulders

Prinja

Raymond

Pimple

2020

Advances in Orthopedics

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“…Many factors are associated with osteolysis. Di Giacomo et al 39 demonstrated that solely increasing compression was not enough to achieve less coracoid bone graft osteolysis by comparing screw fixation with a more rigid mini-plate fixation in Latarjet procedure. They divided the coracoid bone graft into eight parts when analyzing the osteolysis of the coracoid grafts ( Fig.…”

Section: Grafts Healing With Screw Fixation and Suture-button Fixationmentioning

confidence: 99%

Early Follow‐Up of Arthroscopic Latarjet Procedure with Screw or Suture‐Button Fixation for Recurrent Anterior Shoulder Instability

Wang¹,

Zhou²,

Zhang³

et al. 2020

Orthopaedic Surgery

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Objective To evaluate the early clinical and radiographic results of arthroscopic Latarjet procedure using screw or suture‐button fixation in patients with recurrent anterior shoulder dislocation. Methods Twelve patients who underwent arthroscopic Latarjet procedure between January 2015 and December 2018 at our institution were retrospectively studied. Data of the patients' history, including age, gender, side of affected arm, body mass index (BMI), and the number of dislocations since fist dislocation were collected. Preoperative and postoperative clinical follow‐up data were evaluated using Walch–Duplay score, American Shoulder and Elbow Society (ASES) score, and modified Rowe score. Active external rotation and active internal rotation at 90° of abduction as well as active elevation were evaluated preoperatively and postoperatively. The position and healing condition of the transferred coracoid bony graft were also assessed using computed tomography (CT) and Mimics 19.0 software. Results Mean follow‐up was 24.9 months (range, 13 to 53 months) of all patients. At final follow‐up, the average ASES score (preoperative vs postoperative values) had improved from 68.9 ± 7.9 to 91.1 ± 6.1 in screw fixation group and 68.9 ± 8.9 to 87.5 ± 6.7 in suture‐button fixation group; the average Rowe score (preoperative vs postoperative values) had improved from 25.0 ± 8.4 to 92.5 ± 4.2 in screw fixation group and 21.7 ± 13.7 to 93.3 ± 4.1 in suture‐button fixation group; the average of Walch–Duplay score (preoperative vs postoperative values) had improved from 12.5 ± 15.1 to 91.7 ± 4.1 in screw fixation group and 18.3 ± 20.7 to 88.3 ± 7.5 in button fixation group. The forward flexion was 175.0° ± 8.4° preoperatively and 178.3° ± 4.1° postoperatively in screw fixation group while 174.8° ± 10.2° preoperatively and 175.0° ± 5.5° postoperatively in suture‐button fixation group. The active external rotation was 77.5° ± 5.2° preoperatively and 71.7° ± 4.1° postoperatively in screw fixation group while 72.5° ± 6.9° preoperatively and 68.3° ± 7.5° postoperatively in suture‐button fixation group. The average of active internal rotation was 66.7° ± 6.1° preoperatively and 67.5° ± 6.1° postoperatively in screw fixation group while 68.3° ± 11.3° preoperatively and 66.7° ± 7.5° postoperatively in suture‐button fixation group. In postoperative CT scan, 91.7% grafts midline center were located at or under the equator in the en face view; 75% of the bone blocks were flush to the glenoid face in the axial view, with only two grafts exhibiting slight medial placement in screw fixation group (33.3%) and one graft exhibiting slight lateral placement in suture‐button fixation group (16.7%). All grafts achieved bone union. Graft absorption mostly occurred outside of the “best‐fit” circle. The average bony absorption rates of the coracoid grafts were 25.2% and 10.18% in screw fixation group and suture‐button fixation group, respectively, at 6 months postoperative follow‐up. Conclusion Both suture‐button fixation and screw fixation techniques in arth...

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“…As demonstrated by Griesser et al, 9 nonunion of the coracoid bone block to the native bone is a known complication of the Latarjet procedure; however, no correlation exists between healing rate and symptoms. Giacomo et al 8 similarly noted a high prevalence of osteolysis of the coracoid graft in a CT evaluation of 26 patients. The authors found osteolysis most frequently at the proximal, superficial aspect of the coracoid bone block but did not find any correlation between degree of osteolysis and clinical findings.…”

Section: Discussionmentioning

confidence: 94%

The Latarjet Procedure at the National Football League Scouting Combine: An Imaging and Performance Analysis

Lebus

Chahla

Sánchez

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:The Latarjet procedure is commonly performed in the setting of glenoid bone loss for treatment of recurrent anterior shoulder instability; however, little is known regarding the outcomes of this procedure in elite American football players.Purpose:(1) Determine the prevalence, clinical features, and imaging findings of elite college football athletes who present to the National Football League (NFL) Combine with a previous Latarjet procedure and (2) describe these athletes’ performance in the NFL in terms of draft status and initial playing time.Study Design:Case series; Level of evidence, 4.Methods:After review of all football players who participated in the NFL Combine from 2009 to 2016, any player with a previous Latarjet procedure was included in this study. Medical records, position on the field, and draft position were recorded for each player. In addition, imaging studies were reviewed to determine fixation type, hardware complications, and status of the bone block. For those players who were ultimately drafted, performance was assessed based on games played and started, total snaps, and percentage of eligible snaps in which the player participated during his rookie season.Results:Overall, 13 of 2617 (<1%) players at the combine were identified with a previous Latarjet procedure. Radiographically, 8 of 13 (61%) showed 2-screw fixation, while 5 of 13 (39%) had 1 screw. Of the 13 players, 6 (46%) players demonstrated hardware complications. All players had evidence of degenerative changes on plain radiographs, with 10 (77%) graded as mild, 1 (8%) as moderate, and 2 (15%) as severe according to the Samilson Prieto classification. Six of the 13 (46%) players went undrafted, while the remaining 7 (54%) were drafted; however, no player participated in more than half of the plays for which he was eligible during his rookie season.Conclusion:Only a small percentage of players at the NFL Combine (<1%) had undergone a Latarjet procedure. High rates of postoperative complications and radiographically confirmed degenerative change were observed. Athletes who had undergone a Latarjet procedure demonstrated a variable amount of playing time, but none participated in more than half of their eligible plays during their rookie season.

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Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

Cited by 42 publications

References 17 publications

A Biomechanical Comparison of Two Techniques of Latarjet Procedure in Cadaveric Shoulders

A Biomechanical Comparison of Two Techniques of Latarjet Procedure in Cadaveric Shoulders

Early Follow‐Up of Arthroscopic Latarjet Procedure with Screw or Suture‐Button Fixation for Recurrent Anterior Shoulder Instability

The Latarjet Procedure at the National Football League Scouting Combine: An Imaging and Performance Analysis

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