title: A guided surgical approach and novel fixation method for arthroscopic Latarjet.
abstract: BACKGROUND
  Most of the complications of the Latarjet procedure are related to the bone block positioning and use of screws. The purpose of this study was to evaluate if an arthroscopic Latarjet guiding system improves accuracy of bone block positioning and if suture button fixation could be an alternative to screw fixation in allowing bone block healing and avoiding complications.
  
  
  METHODS
  Seventy-six patients (mean age, 27 years) underwent an arthroscopic Latarjet procedure with a guided surgical approach and suture button fixation. Bone graft union and positioning accuracy were assessed by postoperative computed tomography imaging. Clinical examinations were performed at each visit.
  
  
  RESULTS
  At a mean of 14 months (range, 6-24 months) postoperatively, 75 of 76 patients had a stable shoulder. No neurologic complications were observed; no patients have required further surgery. The coracoid graft was positioned strictly tangential to the glenoid surface in 96% of the cases and below the equator in 93%. The coracoid graft healed in 69 patients (91%).
  
  
  CONCLUSIONS
  A guided surgical approach optimizes graft positioning accuracy. Suture button fixation can be an alternative to screw fixation, obtaining an excellent rate of bone union. Neurologic and hardware complications, classically reported with screw fixation, have not been observed with this guided technique and novel fixation method.
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France. Electronic address: boileau.p@chu-nice.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Boileau
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Gendre
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Baba
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Charles-Édouard
authors.initials: CÉ
authors.lastname: Thélu
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Toby
authors.initials: T
authors.lastname: Baring
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Gonzalez
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Trojani
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001863:Bone Screws; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012540:Scapula / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D014945:Wound Healing; D055815:Young Adult
keywords: Latarjet procedure; arthroscopic Latarjet; cortical button; glenoid bone loss; shoulder instability