Graft position and fusion rate following arthroscopic Latarjet.
OBJECTIVE
The arthroscopic Latarjet procedure is recently becoming an increasingly popular technique. Nevertheless, position and fusion of the autograft had not been well studied yet. The purpose of this study was to assess the positioning of the coracoid graft and the fusion rate on CT scan in the arthroscopic Latarjet procedure.


METHODS
The study design was a prospective series of 19 consecutive patients who received arthroscopic Latarjet procedure. Radiological assessment on CT scan performed 3 months post-operatively included an analysis of the fusion and the position of the coracoid bone graft using a validated method. 02:30-04:20 was considered an ideal positioning in the sagittal view. In the axial view, the positioning was considered as flush, congruent, medial, too medial, or lateral.


RESULTS
The median age of patients was 27.6 (±6.9). Mean operative time was of 161 min ±34.8. The fusion rate was of 78 %. Coracoid grafts were positioned 01:52 h (56° ± 14°) to 4:04 h (122° ± 12.5°). In the axial view, 32 % of the grafts positioning were considered as flush, 38 % as congruent, 30 % as medial, and 6 % too medial. No lateral position was noted. Two complications occurred, one graft fracture during screwing requiring opening conversion and an early case of osteolysis in a medial-positioned graft.


CONCLUSIONS
The arthroscopic Latarjet procedure is a technically challenging technique that provides satisfactory fusion rate and graft positioning with a low complication rate. The clinical importance of this study lies in the observation that it is the first study to evaluate the position of the coracoid bone graft in arthroscopic Latarjet according to a detailed and validated method.


METHODS
IV.
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Laurent
L
Casabianca
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Antoine
A
Gerometta
Department of Radiology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Audrey
A
Massein
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Frederic
F
Khiami
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Romain
R
Rousseau
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Alexandre
A
Hardy
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France.
Hugues
H
Pascal-Moussellard
Department of Orthopaedic Surgery and Sports Traumatology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, 47 Boulevard de l'Hôpital, 75013, Paris, France. philippeloriaut@hotmail.com.
Philippe
P
Loriaut
D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D061646:Operative Time; D010014:Osteolysis / Q000209:etiology; D011446:Prospective Studies; D012540:Scapula / Q000000981:diagnostic imaging / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D055815:Young Adult
Bone graft positioning; CT scan; Dislocation; Instability; Latarjet; Shoulder arthroscopy