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Archives of Orthopaedic and Trauma Surgery

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01-11-2013 | Arthroscopy and Sports Medicine

CT-based quantitative assessment of the surface size and en-face position of the coracoid block post-Latarjet procedure

Authors: Tobias M. Kraus, Frank Martetschläger, Nicolas Graveleau, Shahnaz Klouche, Thomas Freude, Ulrich Stöckle, Philippe Hardy

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2013

Abstract

Background

The success of shoulder stabilization with the Latarjet procedure might depend on the size of the bone graft and the positioning of the coracoid at the glenoid. The aim of this study was to quantitatively assess the surface of the coracoid bone graft and to assess its positioning in the en-face view.

Method

A series of 21 patients (17 men, 4 women, 26.1 ± 6.8 years—9 right, 12 left shoulders) were prospectively included and followed up with CT scans between December 2010 and April 2012 at an average of 2.4 ± 0.7 months postoperatively. The retrospective analysis of the CT scans was performed with Osirix™ software. The coracoid surface was measured (cm²) in the sagittal plane. The positioning in relation to the center of the circumscribed circle of the glenoid was determined in the en-face clock face view of the glenoid.

Results

The grafts had a mean surface of 1.61 ± 0.51 cm² (mean ± standard deviation). The coracoid grafts were located between 01:05 hours (32.5°) and 05:33 hours (166.6°). Mean positioning was 02:00 hours (59.8° ± 16.1°) to 04:26 hours (133.0° ± 16.9°). The extent of the grafts was 73.2° ± 14.3°.

Discussion

The positioning of the coracoid graft on the clock face of the glenoid is situated in the decisive zone of 02:30–04:20 hours. The mean surface of the graft is smaller than expected from anatomical studies, but restores in defect situations bone stock in the potential defect areas at the anterior glenoid rim.

Level of evidence

Level IV, prospective case series, treatment study.

Meyer A, Klouche S, Bauer T, Rousselin B, Hardy P (2011) Residual inferior glenohumeral instability after arthroscopic Bankart repair: radiological evaluation and functional results. Orthop Traumatol Surg Res 97(6):590–594. doi:10.1016/j.otsr.2011.04.009 PubMedCrossRef

Boileau P, Villalba M, Hery JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 88(8):1755–1763. doi:10.2106/JBJS.E.00817 PubMedCrossRef

Burkhart SS, De Beer JF (2000) Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 16(7):677–694PubMedCrossRef

Thomazeau H, Courage O, Barth J, Pelegri C, Charousset C, Lespagnol F, Nourissat G, Audebert S, Guillo S, Toussaint B, Lafosse L, Bradel J, Veillard D, Boileau P (2010) Can we improve the indication for Bankart arthroscopic repair? A preliminary clinical study using the ISIS score. Orthop Traumatol Surg Res 96(8 Suppl):S77–S83. doi:10.1016/j.otsr.2010.09.007 PubMedCrossRef

Sommaire C, Penz C, Clavert P, Klouche S, Hardy P, Kempf JF (2012) Recurrence after arthroscopic Bankart repair: is quantitative radiological analysis of bone loss of any predictive value? Orthop Traumatol Surg Res 98(5):514–519. doi:10.1016/j.otsr.2012.03.015 PubMedCrossRef

Lafosse L, Boyle S (2010) Arthroscopic Latarjet procedure. J Shoulder Elbow Surg 19(2 Suppl):2–12. doi:10.1016/j.jse.2009.12.010 PubMedCrossRef

Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49(8):994–997PubMed

Young AA, Maia R, Berhouet J, Walch G (2011) Open Latarjet procedure for management of bone loss in anterior instability of the glenohumeral joint. J Shoulder Elbow Surg 20(2 Suppl):S61–S69. doi:10.1016/j.jse.2010.07.022 PubMedCrossRef

Hovelius L, Sandstrom B, Olofsson A, Svensson O, Rahme H (2011) The effect of capsular repair, bone block healing, and position on the results of the Bristow-Latarjet procedure (study III): long-term follow-up in 319 shoulders. J Shoulder Elbow Surg. doi:10.1016/j.jse.2011.03.020

10.

Boileau P, Mercier N, Roussanne Y, Thelu CE, Old J (2010) Arthroscopic Bankart-Bristow-Latarjet procedure: the development and early results of a safe and reproducible technique. Arthroscopy 26(11):1434–1450. doi:10.1016/j.arthro.2010.07.011 PubMedCrossRef

11.

Meyer DC, Moor BK, Gerber C, Ek ET (2012) Accurate coracoid graft placement through use of a drill guide for the Latarjet procedure. J Shoulder Elbow Surg. doi:10.1016/j.jse.2012.06.012

12.

Wellmann M, Petersen W, Zantop T, Herbort M, Kobbe P, Raschke MJ, Hurschler C (2009) Open shoulder repair of osseous glenoid defects: biomechanical effectiveness of the Latarjet procedure versus a contoured structural bone graft. Am J Sports Med 37(1):87–94. doi:10.1177/0363546508326714 PubMedCrossRef

13.

Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP (2007) Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy 23(10):1033–1041. doi:10.1016/j.arthro.2007.08.009 PubMedCrossRef

14.

Hovelius L, Sandstrom B, Saebo M (2006) One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for 15 years: study II-the evolution of dislocation arthropathy. J Shoulder Elbow Surg 15(3):279–289. doi:10.1016/j.jse.2005.09.014 PubMedCrossRef

15.

Saito H, Itoi E, Sugaya H, Minagawa H, Yamamoto N, Tuoheti Y (2005) Location of the glenoid defect in shoulders with recurrent anterior dislocation. Am J Sports Med 33(6):889–893. doi:10.1177/0363546504271521 PubMedCrossRef

16.

Bernageau J, Patte D, Debeyre J, Ferrane J (1976) Value of the glenoid profil in recurrent luxations of the shoulder. Rev Chir Orthop Reparatrice Appar Mot 62(2 suppl):142–147PubMed

17.

Edwards TB, Boulahia A, Walch G (2003) Radiographic analysis of bone defects in chronic anterior shoulder instability. Arthroscopy 19(7):732–739PubMedCrossRef

18.

Magarelli N, Milano G, Baudi P, Santagada DA, Righi P, Spina V, Leone A, Amelia R, Fabbriciani C, Bonomo L (2012) Comparison between 2D and 3D computed tomography evaluation of glenoid bone defect in unilateral anterior gleno-humeral instability. Radiol Med 117(1):102–111. doi:10.1007/s11547-011-0712-7 PubMedCrossRef

19.

Chuang TY, Adams CR, Burkhart SS (2008) Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability. Arthroscopy 24(4):376–382. doi:10.1016/j.arthro.2007.10.008 PubMedCrossRef

20.

Nofsinger C, Browning B, Burkhart SS, Pedowitz RA (2011) Objective preoperative measurement of anterior glenoid bone loss: a pilot study of a computer-based method using unilateral 3-dimensional computed tomography. Arthroscopy 27(3):322–329. doi:10.1016/j.arthro.2010.09.007 PubMedCrossRef

21.

Burkhart SS, Debeer JF, Tehrany AM, Parten PM (2002) Quantifying glenoid bone loss arthroscopically in shoulder instability. Arthroscopy 18(5):488–491. doi:10.1053/jars.2002.32212 PubMedCrossRef

22.

Burkhart SS (2007) The bare spot of the glenoid. Arthroscopy 23(4):449; author reply 449–450. doi:10.1016/j.arthro.2006.12.018

23.

Hantes ME, Venouziou A, Bargiotas KA, Metafratzi Z, Karantanas A, Malizos KN (2010) Repair of an anteroinferior glenoid defect by the latarjet procedure: quantitative assessment of the repair by computed tomography. Arthroscopy 26(8):1021–1026. doi:10.1016/j.arthro.2010.05.016 PubMedCrossRef

24.

Bueno RS, Ikemoto RY, Nascimento LG, Almeida LH, Strose E, Murachovsky J (2012) Correlation of coracoid thickness and glenoid width: an anatomic morphometric analysis. Am J Sports Med 40(7):1664–1667. doi:10.1177/0363546512445997 PubMedCrossRef

25.

Dolan CM, Hariri S, Hart ND, McAdams TR (2011) An anatomic study of the coracoid process as it relates to bone transfer procedures. J Shoulder Elbow Surg 20(3):497–501. doi:10.1016/j.jse.2010.08.015 PubMedCrossRef

26.

Young AA, Baba M, Neyton L, Godeneche A, Walch G (2012) Coracoid graft dimensions after harvesting for the open Latarjet procedure. J Shoulder Elbow Surg. doi:10.1016/j.jse.2012.05.036

27.

Balg F, Boileau P (2007) The instability severity index score: a simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br 89(11):1470–1477. doi:10.1302/0301-620X.89B11.18962 PubMed

28.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174PubMedCrossRef

29.

Millett PJ, Clavert P, Warner JJ (2005) Open operative treatment for anterior shoulder instability: when and why? J Bone Joint Surg Am 87(2):419–432. doi:10.2106/JBJS.D.01921 PubMedCrossRef

30.

Neyton L, Young A, Dawidziak B, Visona E, Hager JP, Fournier Y, Walch G (2012) Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up. J Shoulder Elbow Surg. doi:10.1016/j.jse.2012.01.023

31.

Itoi E, Lee SB, Berglund LJ, Berge LL, An KN (2000) The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 82(1):35–46PubMed

32.

Yamamoto N, Itoi E, Abe H, Kikuchi K, Seki N, Minagawa H, Tuoheti Y (2009) Effect of an anterior glenoid defect on anterior shoulder stability: a cadaveric study. Am J Sports Med 37(5):949–954. doi:10.1177/0363546508330139 PubMedCrossRef

33.

Schmid SL, Farshad M, Catanzaro S, Gerber C (2012) The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients. J Bone Joint Surg Am 94(11):e75. doi:10.2106/JBJS.K.00380 PubMedCrossRef

34.

Martetschlager F, Kraus TM, Hardy P, Millett PJ (2012) Arthroscopic management of anterior shoulder instability with glenoid bone defects. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-012-2198-9

35.

Armitage MS, Elkinson I, Giles JW, Athwal GS (2011) An anatomic, computed tomographic assessment of the coracoid process with special reference to the congruent-arc latarjet procedure. Arthroscopy 27(11):1485–1489. doi:10.1016/j.arthro.2011.06.020 PubMedCrossRef

36.

Di Giacomo G, Costantini A, de Gasperis N, De Vita A, Lin BK, Francone M, Rojas Beccaglia MA, Mastantuono M (2011) Coracoid graft osteolysis after the Latarjet procedure for anteroinferior shoulder instability: a computed tomography scan study of twenty-six patients. J Shoulder Elbow Surg 20(6):989–995. doi:10.1016/j.jse.2010.11.016 PubMedCrossRef

Title: CT-based quantitative assessment of the surface size and en-face position of the coracoid block post-Latarjet procedure
Authors: Tobias M. Kraus
Frank Martetschläger
Nicolas Graveleau
Shahnaz Klouche
Thomas Freude
Ulrich Stöckle
Philippe Hardy
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2013
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-013-1825-3

At a glance: The STEP trials

Springer Medicine

CT-based quantitative assessment of the surface size and en-face position of the coracoid block post-Latarjet procedure

Abstract

Background

Method

Results

Discussion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Discussion

Level of evidence

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