title: Quantitative assessment of the latarjet procedure for large glenoid defects by computed tomography: a coracoid graft can sufficiently restore the glenoid arc.
abstract: BACKGROUND
  Coracoid transfer to a large glenoid defect is considered an excellent method to restore the surface area of the anteroinferior glenoid. However, there is little quantitative evidence supporting whether a coracoid graft can sufficiently restore the glenoid arc.
  
  
  OBJECTIVE
  To assess whether the Latarjet procedure can sufficiently restore the surface area of the glenoid.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  A total of 44 patients who underwent a Latarjet operation for a large glenoid defect between February 2009 and July 2011 were enrolled in this study. Three-dimensional computed tomography was used to calculate the surface areas of the preoperative glenoid defect size and the reconstructed glenoid. Preoperative and postoperative clinical results also were assessed.
  
  
  RESULTS
  At the last follow-up, the mean visual analog scale score for instability during motion improved significantly from 5.1 points (range, 3-10 points) preoperatively to 1.3 points (range, 0-4 points) (P<.001). The mean deficit in external rotation at the side, external rotation at 90° of abduction, and internal rotation to the posterior were 10°±20°, 7°±16°, and 1.9°±4°, respectively (P=.004, .022, and .009, respectively). The overall recurrence rate was 4.5% (2 of 44 shoulders). The mean preoperative glenoid defect size was 157±38 mm2 (range, 141-239 mm2; 25.3%±6% of the intact glenoid surface). The mean surface area of the coracoid graft used for reconstruction was 152±34 mm2 (range, 146-236 mm2; 24.8%±5% of the intact glenoid surface). After the Latarjet procedure, the mean surface area of the reconstructed glenoid was 706±32 mm2 (range, 639-749 mm2). Finally, postoperative glenoid defect size was 5±11 mm2 (range, 3-28 mm2; 1.5%±2% of the intact glenoid surface).
  
  
  CONCLUSIONS
  The Latarjet procedure can provide satisfactory outcomes, including a low recurrence rate and reliable functional recovery. Defects at the anteroinferior glenoid were restored to nearly normal after coracoid transfer by use of the Latarjet procedure, which is an anatomically matched reconstruction.
authors: Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors: Seong Cheol
authors: SC
authors: Moon
authors: Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors: Nam Su
authors: NS
authors: Cho
authors: Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea shoulderrhee@hanmail.net.
authors: Yong Girl
authors: YG
authors: Rhee
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D012540:Scapula / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Latarjet; anterior instability; computed tomography; glenoid defect; outcome; restoration; shoulder