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Coracoid graft positioning in the Latarjet procedure

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The success of shoulder stabilization with the Latarjet procedure depends on the correct positioning of the coracoid graft at the glenoid. The aim of this study was to assess intra-observer reproducibility and inter-observer reproducibility of a new standardized CT scan analysis for coracoid graft positioning in the axial plane after the Latarjet procedure and to assess the positioning in the study group.

Methods

A consecutive series of 27 patients (22 men, 5 woman, 26.1 ± 6.4 years—13 right, 14 left shoulders) were followed up with CT scans between 2010 and 2012. The analysis of the CT scans (2.4 ± 0.7 months postoperatively) was performed with Osirix™ software. The assessment included two criteria in the axial plane: relation of the graft to the articular surface of the glenoid and impingement of the graft with the maximal humeral head circumference. Grafts were judged to be lateral, congruent, flush or medial. The strength of intra-observer agreement and inter-observer agreement was measured by the Kappa coefficient.

Results

The Kappa coefficient for intra-observer agreement was “substantial” (K = 0.64 ± 0.14, z = 4.6) to “almost perfect” (K = 0.81 ± 0.14, z = 5.7). The Kappa coefficient for inter-observer variability was “substantial” (K = 0.59 ± 0.14, z = 4.3) to “almost perfect” (K = 0.89 ± 0.14, z = 6.0). In our study, in the axial plane, 3 (11 %) transplants were lateral; 6 (22 %) transplants were congruent; 16 (60 %) flush and 2 (7 %) medial.

Conclusion

This standardized CT scan analysis after Latarjet procedure has shown to accurately describe graft positioning in the axial plane with both good intra-observer reproducibility and inter-observer reproducibility.

Level of evidence

Case series, treatment study, Level IV.

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References

  1. Allain J, Goutallier D, Glorion C (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80(6):841–852

    CAS  PubMed  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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):677–694

    Article  CAS  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. Cassagnaud X, Maynou C, Mestdagh H (2003) Clinical and computed tomography results of 106 Latarjet-Patte procedures at mean 7.5 year follow-up. Rev Chir Orthop Reparatrice Appar Mot 89(8):683–692

    CAS  PubMed  Google Scholar 

  10. Doursounian L, Debet-Mejean A, Chetboun A, Nourissat G (2009) Bristow-Latarjet procedure with specific instrumentation: study of 34 cases. Int Orthop 33(4):1031–1036

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. Hovelius L, Korner L, Lundberg B, Akermark C, Herberts P, Wredmark T, Berg E (1983) The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure. J Bone Joint Surg Am 65(7):926–934

    CAS  PubMed  Google Scholar 

  13. Hovelius L, Sandstrom B, Olofsson A, Svensson O, Rahme H (2012) 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 21(5):647–660

    Article  PubMed  Google Scholar 

  14. Huguet D, Pietu G, Bresson C, Potaux F, Letenneur J (1996) Anterior instability of the shoulder in athletes: apropos of 51 cases of stabilization using the Latarjet-Patte intervention. Acta Orthop Belg 62(4):200–206

    CAS  PubMed  Google Scholar 

  15. 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):35–46

    CAS  PubMed  Google Scholar 

  16. Lafosse L, Boyle S (2010) Arthroscopic Latarjet procedure. J Shoulder Elbow Surg 19(2 Suppl):2–12

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  19. Longo UG, Loppini M, Rizzello G, Romeo G, Huijsmans PE, Denaro V (2013) Glenoid and humeral head bone loss in traumatic anterior glenohumeral instability: a systematic review. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2403-5

    Google Scholar 

  20. Lunn JV, Castellano-Rosa J, Walch G (2008) Recurrent anterior dislocation after the Latarjet procedure: outcome after revision using a modified Eden-Hybinette operation. J Shoulder Elbow Surg 17(5):744–750

    Article  PubMed  Google Scholar 

  21. 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

    Google Scholar 

  22. 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

    Article  CAS  PubMed  Google Scholar 

  23. Meyer DC, Moor BK, Gerber C, Ek ET (2013) Accurate coracoid graft placement through use of a drill guide for the Latarjet procedure. J Shoulder Elbow Surg 22(5):701–708

    Article  PubMed  Google Scholar 

  24. 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 21(12):1721–1727

    Article  PubMed  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

  26. 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

    Article  CAS  PubMed  Google Scholar 

  27. Wellmann M, de Ferrari H, Smith T, Petersen W, Siebert CH, Agneskirchner JD, Hurschler C (2012) Biomechanical investigation of the stabilization principle of the Latarjet procedure. Arch Orthop Trauma Surg 132(3):377–386

    Article  CAS  PubMed  Google Scholar 

  28. 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

    Article  PubMed  Google Scholar 

  29. 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

    Article  PubMed  Google Scholar 

  30. Young AA, Baba M, Neyton L, Godeneche A, Walch G (2013) Coracoid graft dimensions after harvesting for the open Latarjet procedure. J Shoulder Elbow Surg 22(4):485–488

    Article  PubMed  Google Scholar 

  31. 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

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. BG Trauma Center Tübingen, Eberhard-Karls-Universität, 72076, Tübingen, Germany

    Tobias M. Kraus

  2. Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France

    Tobias M. Kraus, Erwan Pansard, Shahnaz Klouche & Philippe Hardy

  3. Clinique du Sport Paris V, 75005, Paris, France

    Nicolas Graveleau & Yoann Bohu

  4. Université de Versailles Saint-Quentin, 78035, Versailles, France

    Philippe Hardy

  5. Hôpital Ambroise Paré, 9, Avenue Charles de Gaulle, 92100, Boulogne, Paris, France

    Philippe Hardy

Authors
  1. Tobias M. Kraus
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  2. Nicolas Graveleau
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  5. Shahnaz Klouche
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  6. Philippe Hardy
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Correspondence to Philippe Hardy.

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Kraus, T.M., Graveleau, N., Bohu, Y. et al. Coracoid graft positioning in the Latarjet procedure. Knee Surg Sports Traumatol Arthrosc 24, 496–501 (2016). https://doi.org/10.1007/s00167-013-2651-4

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  • DOI: https://doi.org/10.1007/s00167-013-2651-4

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