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International Orthopaedics

, Volume 42, Issue 5, pp 1119–1128 | Cite as

Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)—computed tomography evaluation at a short term follow-up. Part II

  • Bartłomiej Kordasiewicz
  • Maciej Kicinski
  • Konrad Małachowski
  • Janusz Wieczorek
  • Sławomir Chaberek
  • Stanisław Pomianowski
Original Paper

Abstract

Purpose and hypothesis

The aim of this study was to evaluate and to compare the radiological parameters after arthroscopic and open Latarjet technique via evaluation of computed tomography (CT) scans. Our hypothesis was that the radiological results after arthroscopic stabilisation remained in the proximity of those results achieved after open stabilisation.

Material and methods

CT scan evaluation results of patients after primary Latarjet procedure were analysed. Patients operated on between 2006 and 2011 using an open technique composed the OPEN group and patients operated on arthroscopically between 2011 and 2013 composed the ARTHRO group. Forty-three out of 55 shoulders (78.2%) in OPEN and 62 out of 64 shoulders (95.3%) in ARTHRO were available for CT scan evaluation. The average age at surgery was 28 years in OPEN and 26 years in ARTHRO. The mean follow-up was 54.2 months in OPEN and 23.4 months in ARTHRO. CT scan evaluation was used to assess graft fusion and osteolysis. Bone block position and screw orientation were assessed in the axial and the sagittal views. The subscapularis muscle fatty infiltration was evaluated according to Goutallier classification.

Results

The non-union rate was significantly higher in OPEN than in ARTHRO: 5 (11.9%) versus 1 (1.7%) (p < 0.05). The total graft osteolysis was significantly higher in the OPEN group: five cases (11.9%) versus zero in ARTHRO (p < 0.05). Graft fracture incidence was comparable in both groups: in two patients in ARTHRO (3.3%) and one case (2.4%) in the OPEN group (p > 0.05). These results should be evaluated very carefully due to significant difference in the follow-up of both groups. A significantly higher rate of partial graft osteolysis at the level of the superior screw was reported in ARTHRO with 32 patients (53.3%) versus 10 (23.8%) in OPEN (p < 0.05). In the axial view, 78.4% of patients in ARTHRO and 80.5% in OPEN had the coracoid bone block in an acceptable position (between 4 mm medially and 2 mm laterally). In the sagittal plane, the bone block was in an acceptable position between 2 and 5 o’clock in 86.7% of patients in ARTHRO and 90.2% in OPEN (p > 0.05). However, in the position between 3 and 5 o’clock there were 56.7% of the grafts in ARTHRO versus 87.8% in OPEN (p < 0.05). The screws were more parallel to the glenoid surface in ARTHRO—the angles were 12.3° for the inferior screw and 12.6° for the superior one. These angles in the OPEN group were respectively 15° and 17° (p < 0.05 and for the superior screw). There was no significant difference in the presence of fatty infiltration of the subscapularis muscle.

Conclusions

Arthroscopic Latarjet stabilisation showed satisfactory radiographic results, comparable to the open procedure, however the short-term follow-up can bias this evaluation. Graft healing rate was very high in the arthroscopic technique, but yet osteolysis of the superior part of the graft and more superior graft position in the sagittal view were significantly different when compared to the open technique. The screw position was slightly more parallel to the glenoid via the arthroscopic technique. We recommend both further investigation and development of the arthroscopic technique.

Level of evidence: III.

Keywords

Arthroscopic Latarjet stabilisation Coracoid transfer Open Latarjet stabilisation Shoulder instability 

References

  1. 1.
    Latarjet M (1954) Treatment of recurrent dislocation of the shoulder. Lyon Chir 49:994–997PubMedGoogle Scholar
  2. 2.
    Bhatia S, Frank RM, Ghodara NS et al (2014) The outcomes and surgical techniques of the Latarjet procedure. Arthroscopy 30:227–235.  https://doi.org/10.1016/j.arthro.2013.10.013 CrossRefPubMedGoogle Scholar
  3. 3.
    Paladini P, Singla R, Merolla G, Porcellini G (2016) Latarjet procedure: is the coracoid enough to restore the glenoid surface? Int Orthop 40:1675–1681.  https://doi.org/10.1007/s00264-015-3093-z CrossRefPubMedGoogle Scholar
  4. 4.
    Edwards BT, Walch G (2012) The Latarjet procedure for recurrent anterior shoulder instability: rationale and technique. Oper Tech Sports Med 20:57–64.  https://doi.org/10.1053/j.otsm.2012.03.007 CrossRefGoogle Scholar
  5. 5.
    Allain J, Goutallier D, Glorion C, Surgery J (1998) Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80:841–852CrossRefPubMedGoogle Scholar
  6. 6.
    Ladermann A, Lubbeke A, Stern R et al (2013) Risk factors for dislocation arthropathy after Latarjet procedure: a long-term study. Int Orthop 37:1093–1098.  https://doi.org/10.1007/s00264-013-1848-y CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Lafosse L, Lejeune E, Bouchard A et al (2007) The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability. Arthroscopy 23:1242e1–1242e5.  https://doi.org/10.1016/j.arthro.2007.06.008 CrossRefGoogle Scholar
  8. 8.
    Lafosse L, Boyle S (2010) Arthroscopic Latarjet procedure. J Shoulder Elb Surg 19:2–12.  https://doi.org/10.1016/j.jse.2009.12.010 CrossRefGoogle Scholar
  9. 9.
    Dumont GD, Fogerty S, Rosso C, Lafosse L (2014) The arthroscopic latarjet procedure for anterior shoulder instability: 5-year minimum follow-up. Am J Sports Med 42:2560–2566.  https://doi.org/10.1177/0363546514544682 CrossRefPubMedGoogle Scholar
  10. 10.
    Boileau P, Gendre P, Baba M et al (2016) A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elb Surg 25:78–89.  https://doi.org/10.1016/j.jse.2015.06.001 CrossRefGoogle Scholar
  11. 11.
    Wellmann M, Petersen W, Zantop T et al (2009) Open shoulder repair of osseous glenoid defects: biomechanical effectiveness of the Latarjet procedure versus a contoured structural bone graft. Am J Sports Med 37:87–94.  https://doi.org/10.1177/0363546508326714 CrossRefPubMedGoogle Scholar
  12. 12.
    Hovelius L, Sandström B, Sundgren K, Saebö M (2004) One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study I - clinical results. J Shoulder Elb Surg 13:509–516.  https://doi.org/10.1016/j.jse.2004.02.013 CrossRefGoogle Scholar
  13. 13.
    Mizuno N, Denard PJ, Raiss P et al (2014) Long-term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elb Surg 23:1691–1699.  https://doi.org/10.1016/j.jse.2014.02.015 CrossRefGoogle Scholar
  14. 14.
    Meyer DC, Moor BK, Gerber C et al (2013) Accurate coracoid graft placement through use of a drill guide for the Latarjet procedure. J Shoulder Elb Surg 22:701–708.  https://doi.org/10.1016/j.jse.2012.06.012 CrossRefGoogle Scholar
  15. 15.
    Casabianca L, Gerometta A, Massein A et al (2016) Graft position and fusion rate following arthroscopic Latarjet. Knee Surg Sports Traumatol Arthrosc 24:507–512.  https://doi.org/10.1007/s00167-015-3551-6 CrossRefPubMedGoogle Scholar
  16. 16.
    Kany J, Flamand O, Grimberg J et al (2016) Arthroscopic Latarjet procedure: is optimal positioning of the bone block and screws possible? A prospective computed tomography scan analysis. J Shoulder Elb Surg 25:69–77.  https://doi.org/10.1016/j.jse.2015.06.010 CrossRefGoogle Scholar
  17. 17.
    Itoi E, Lee S-B, Amrami KK et al (2003) Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography. Am J Sports Med 31:112–118CrossRefPubMedGoogle Scholar
  18. 18.
    Doursounian L, Debet-Mejean A, Chetboun A, Nourissat G (2009) Bristow-Latarjet procedure with specific instrumentation: study of 34 cases. Int Orthop 33:1031–1036.  https://doi.org/10.1007/s00264-008-0606-z CrossRefPubMedGoogle Scholar
  19. 19.
    Clavert P, Koch G, Neyton L et al (2016) Is anterior glenoid bone block position reliably assessed by standard radiography? A cadaver study. Orthop Traumatol Surg Res 102:S281–S285.  https://doi.org/10.1016/j.otsr.2016.08.005 CrossRefPubMedGoogle Scholar
  20. 20.
    Kordasiewicz B, Malachowski K, Kicinski M et al (2017) Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (Latarjet)-clinical results at short term follow-up. Int Orthop 41(5):1023–1033.  https://doi.org/10.1007/s00264-016-3372-3 CrossRefPubMedGoogle Scholar
  21. 21.
    Kraus TM, Martetschläger F, Graveleau N et al (2013) CT-based quantitative assessment of the surface size and en-face position of the coracoid block post-Latarjet procedure. Arch Orthop Trauma Surg 133:1543–1548.  https://doi.org/10.1007/s00402-013-1825-3 CrossRefPubMedGoogle Scholar
  22. 22.
    Ladermann A, Denard PJ, Burkhart SS (2012) Injury of the suprascapular nerve during latarjet procedure: an anatomic study. Arthroscopy 28:316–321.  https://doi.org/10.1016/j.arthro.2011.08.307 CrossRefPubMedGoogle Scholar
  23. 23.
    Goutallier D, Postel JM, Bernageau J et al (1995) Fatty infiltration of disrupted rotator cuff muscles. Rev Rhum Engl Ed 62:415–422PubMedGoogle Scholar
  24. 24.
    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 Elb Surg 17:744–750.  https://doi.org/10.1016/j.jse.2008.03.002 CrossRefGoogle Scholar
  25. 25.
    Hovelius L, Sandstrom B, Saebo M (2006) One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study II—the evolution of dislocation arthropathy. J Shoulder Elb Surg 15:279–289.  https://doi.org/10.1016/j.jse.2005.09.014 CrossRefGoogle Scholar
  26. 26.
    Hovelius L, Sandström B, Olofsson A et al (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 Elb Surg 21:647–660.  https://doi.org/10.1016/j.jse.2011.03.020 CrossRefGoogle Scholar
  27. 27.
    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:e75.  https://doi.org/10.2106/JBJS.K.00380 CrossRefPubMedGoogle Scholar
  28. 28.
    Hovelius L, Eriksson K, Fredin H et al (1983) Recurrences after initial dislocation of the shoulder. Results of a prospective study of treatment. J Bone Joint Surg Am 65:343–349CrossRefPubMedGoogle Scholar
  29. 29.
    Walch G (1991) Recurrent anterior shoulder instability [in French]. Rev Chir Orthop Reparatrice Appar Mot 77(Suppl 1):177–191Google Scholar
  30. 30.
    Shah AA, Butler RB, Romanowski J et al (2012) Short-term complications of the Latarjet procedure. J Bone Joint Surg Am 94:495–501.  https://doi.org/10.2106/JBJS.J.01830 CrossRefPubMedGoogle Scholar
  31. 31.
    Butt U, Charalambous CP (2012) Complications associated with open coracoid transfer procedures for shoulder instability. J Shoulder Elb Surg 21:1110–1119.  https://doi.org/10.1016/j.jse.2012.02.008 CrossRefGoogle Scholar
  32. 32.
    Haeni DL, Opsomer G, Sood A et al (2016) Three-dimensional volume measurement of coracoid graft osteolysis after arthroscopic Latarjet procedure. J Shoulder Elb Surg.  https://doi.org/10.1016/j.jse.2016.08.007
  33. 33.
    Di Giacomo G, Costantini A, De Gasperis N et al (2011) Coracoid graft osteolysis after the Latarjet procedure for anteroinferior shoulder instability: a computed tomography scan study of twenty-six patients. J Shoulder Elb Surg 20:989–995.  https://doi.org/10.1016/j.jse.2010.11.016 CrossRefGoogle Scholar
  34. 34.
    Moroder P, Blocher M, Auffarth A et al (2014) Clinical and computed tomography-radiologic outcome after bony glenoid augmentation in recurrent anterior shoulder instability without significant glenoid bone loss. J Shoulder Elb Surg 23:420–426.  https://doi.org/10.1016/j.jse.2013.07.048 CrossRefGoogle Scholar
  35. 35.
    Boileau P, Mercier N, Roussanne Y et al (2010) Arthroscopic Bankart-Bristow-Latarjet procedure: the development and early results of a safe and reproducible technique. Arthroscopy 26:1434–1450.  https://doi.org/10.1016/j.arthro.2010.07.011 CrossRefPubMedGoogle Scholar
  36. 36.
    Cunningham G, Benchouk S, Kherad O, Lädermann A (2016) Comparison of arthroscopic and open Latarjet with a learning curve analysis. Knee Surg Sports Traumatol Arthrosc 24:540–545.  https://doi.org/10.1007/s00167-015-3910-3 CrossRefPubMedGoogle Scholar
  37. 37.
    Zumstein V, Kraljevic M, Conzen A et al (2014) Thickness distribution of the glenohumeral joint cartilage: a quantitative study using computed tomography. Surg Radiol Anat 36:327–331.  https://doi.org/10.1007/s00276-013-1221-2 CrossRefPubMedGoogle Scholar
  38. 38.
    Metais P, Clavert P, Barth J et al (2016) Preliminary clinical outcomes of Latarjet-Patte coracoid transfer by arthroscopy vs. open surgery: prospective multicentre study of 390 cases. Orthop Traumatol Surg Res 102:S271–S276.  https://doi.org/10.1016/j.otsr.2016.08.003 CrossRefPubMedGoogle Scholar
  39. 39.
    Maynou C, Cassagnaud X, Mestdagh H (2005) Function of subscapularis after surgical treatment for recurrent instability of the shoulder using a bone-block procedure. J Bone Joint Surg Br 87:1096–1101.  https://doi.org/10.1302/0301-620X.87B8.14605 CrossRefPubMedGoogle Scholar
  40. 40.
    Hardy A, Gerometta A, Granger B et al (2016) Preoperative CT planning of screw length in arthroscopic Latarjet. Knee Surg Sports Traumatol Arthrosc 1–7.  https://doi.org/10.1007/s00167-016-4286-8

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Bartłomiej Kordasiewicz
    • 1
  • Maciej Kicinski
    • 1
  • Konrad Małachowski
    • 1
  • Janusz Wieczorek
    • 1
  • Sławomir Chaberek
    • 1
  • Stanisław Pomianowski
    • 1
  1. 1.SPSK im. A. Grucy, Otwock, Trauma and Orthopaedics DepartmentPostgraduate Medical Education CenterWarsawPoland

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