title: Accuracy of Latarjet graft and screw position after using novel drill guide.
abstract: OBJECTIVE
  For the success of Latarjet procedure a correct graft positioning is mandatory. Furthermore, the correct screw placement is important to avoid cartilage damage and soft tissue irritation. Due to a cadaveric experimental study, the accuracy of graft and screw positioning utilizing a novel drill guide for a minimal-invasive Latarjet procedure was analyzed.
  
  
  METHODS
  Five human fresh-frozen shoulder specimens have been treated in accordance with the Congruent-Arc Latarjet technique using the glenoid bone loss set (Arthrex, Naples, FL, USA) with 3.75 mm cannulated screws throughout a 5 cm skin incision without detachment of the scapularis tendon. All procedures were performed by one single, experienced shoulder surgeon. The accuracy of graft and screw positioning was assessed due to a CT scan.
  
  
  RESULTS
  A noticeable learning curve was noted during the study period as the first surgery took 45 min and the last 33 min. All grafts were correctly positioned with regard to the articular line of the glenoid surface. Impingement with the maximum head circumference was not encountered. The screw positions did not affect the suprascapular nerve. A damage of the graft was not noticed.
  
  
  CONCLUSIONS
  The authors can recommend the usage of the new drill guide tested in this study. It seems to be beneficial in the Latarjet procedure and may ease correct graft positioning and prevent screw misplacement. Compared to fully arthroscopically performed Latarjet procedures it provides much steeper learning curve and seems technically easier and quicker to handle.
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: T O
authors.initials: TO
authors.lastname: Klatte
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. mh@maxhartel.de.
authors.forename: M J
authors.identifier: http://orcid.org/0000-0003-4978-2878
authors.initials: MJ
authors.lastname: Hartel
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Weiser
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hoffmann
authors.affiliation: Department of Neuroanatomy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wehrenberg
authors.affiliation: Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Heinemann
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Rueger
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Briem
mesh_terms: D000369:Aged, 80 and over; D001863:Bone Screws; D016025:Bone Transplantation; D002102:Cadaver; D004867:Equipment Design; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation*; D012540:Scapula / Q000601:surgery*; D000070599:Shoulder Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Drill guide; Glenoid repair; Latarjet; Latarjet graft positioning; Shoulder dislocation