title: Coracoid bone graft resorption after Latarjet procedure is underestimated: a new classification system and a clinical review with computed tomography evaluation.
abstract: BACKGROUND
  This study proposes a simple and reliable classification system to evaluate the severity of the bone resorption of the transferred coracoid bone block after the Latarjet procedure. The incidence and severity of the graft resorption was also investigated.
  
  
  METHODS
  Between January 2009 and January 2012, 63 patients underwent an open Latarjet procedure and were included. Four independent surgeons used the classification system we proposed to evaluate the severity of the graft resorption on the computed tomography scan performed 1 year postoperatively. Each surgeon did the evaluation twice at a 3-month interval. The interobserver and intraobserver reliability of the classification system were analyzed using intraclass correlation coefficients. Among these 63 patients, 57 patients were available for clinical evaluation at 2 years postoperatively.
  
  
  RESULTS
  The American Shoulder and Elbow Surgeons score, Constant-Murley score, and Rowe score were improved significantly after the surgery. No redislocation occurred during follow-up. The incidence of graft resorption was 90.5% based on the computed tomography evaluation. The coracoid graft resorption was classified as grade 0 in 6 patients, grade I in 26, grade II in 25, and grade III in 6. The classification system had excellent interobserver and intraobserver reliability.
  
  
  CONCLUSIONS
  The open Latarjet procedure is effective in treating anterior shoulder instability with marked glenoid bone loss. The incidence of the graft resorption at 1 year postoperatively is high. Our classification system on the graft resorption after Latarjet procedure has good interobserver and intraobserver reliability.
authors.affiliation: Shoulder service, Beijing Jishuitan Hospital, School of Medicine, Peking University, Beijing, China.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Zhu
authors.affiliation: Shoulder service, Beijing Jishuitan Hospital, School of Medicine, Peking University, Beijing, China. Electronic address: chunyanj@hotmail.com.
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Jiang
authors.affiliation: Shoulder service, Beijing Jishuitan Hospital, School of Medicine, Peking University, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Shoulder service, Beijing Jishuitan Hospital, School of Medicine, Peking University, Beijing, China.
authors.forename: Feng-Long
authors.initials: FL
authors.lastname: Li
authors.affiliation: Shoulder service, Beijing Jishuitan Hospital, School of Medicine, Peking University, Beijing, China.
authors.forename: Guan
authors.initials: G
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D001862:Bone Resorption / Q000145:classification* / Q000000981:diagnostic imaging*; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D012540:Scapula / Q000000981:diagnostic imaging* / Q000601:surgery; D012783:Shoulder Dislocation / Q000601:surgery*; D055815:Young Adult
keywords: Latarjet; Recurrent anterior shoulder dislocation; bone resorption; classification; computed tomography; surgery