title: Coracoid graft positioning in the Latarjet procedure.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Case series, treatment study, Level IV.
authors.affiliation: BG Trauma Center Tübingen, Eberhard-Karls-Universität, 72076, Tübingen, Germany.|Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France.
authors.forename: Tobias M
authors.initials: TM
authors.lastname: Kraus
authors.affiliation: Clinique du Sport Paris V, 75005, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Graveleau
authors.affiliation: Clinique du Sport Paris V, 75005, Paris, France.
authors.forename: Yoann
authors.initials: Y
authors.lastname: Bohu
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Pansard
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Klouche
authors.affiliation: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100, Boulogne-Billancourt, France. hardy.ph@gmail.com.|Université de Versailles Saint-Quentin, 78035, Versailles, France. hardy.ph@gmail.com.|Hôpital Ambroise Paré, 9, Avenue Charles de Gaulle, 92100, Boulogne, Paris, France. hardy.ph@gmail.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D058430:Humeral Head / Q000000981:diagnostic imaging; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012540:Scapula / Q000000981:diagnostic imaging / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Bone graft; Coracoid; Instability; Latarjet; Positioning; Shoulder