2017 ISAKOS Biennial Congress Paper #102

 

The Arthroscopic Latarjet with Anterior Capsule Reconstruction. Clinical Outcome and Radiological Evaluation of 52 Cases with a Minimum 2-Year Follow-Up

Yiming Zhu, MD, Beijing CHINA
ChunYan Jiang, MD, PhD, Beijing CHINA

Beijing Jishuitan Hospital, Beijing, Beijing, CHINA

FDA Status Cleared

Summary

We presented the clinical and radiographic outcome of the modified arthroscopic Latarjet procedure at minimum 2 years after the surgery.

Abstract

Background

The purpose of this study is to investigate the clinical and radiographic outcome of the modified arthroscopic Latarjet procedure at minimum 2 years after the surgery.

Methods

From February 2013 to September 2014, 59 patients were treated with the modified arthroscopic Latarjet procedure. Among them 52 patients had more than 2 years’ clinical follow-up. All of these 52 patients had a complete set of CT scans (before surgery, immediately after surgery and 1 year after surgery). The position of the transferred coracoid on the axial view and en-face view of the glenoid and the screw angulation was evaluated on the CT scan performed immediately after the surgery. The bone absorption of the transferred coracoid was evaluated on the CT scan performed at 1 year after the surgery using a classification of coracoid absorption based on the axial cut on CT scan. Four grades are described as follow:
Grade 0 : the cone of the screw head is buried in the coracoid bone graft;
Grade I: only the screw head is exposed outside the coracoid bone graft and the whole screw shaft is inside the bone;
Grade II: part of the screw shaft is exposed outside the coracoid graft and there is still some bone left on the glenoid neck;
Grade III: both of the screw head and shaft are totally exposed with all of the coracoid bone graft absorbed and no bone is left on the glenoid neck.

Results

The average duration of follow-up was 28.4 months ( 24.0-41.7 months). No recurrence happened in all of the patients. The ASES score and Rowe score were improved significantly after the surgery (ASES score: P<0.0001; Rowe score:P<0.0001). No significant restriction of the range of motion was found after the surgery(forward elevation:p=0.785,external rotation:p=0.484;internal rotation:p=0.258). The transferred coracoid was level with the glenoid in all of the cases. The transferred coracoid was placed below the equator in 47 out of the 52 cases (90.4%). The orientation of the screw was 22.6±10.6°. At 1 year after the surgery, The bone absorption around the proximal screw was either same as or even worse than that around the distal screw.

Conclusions

The modified arthroscopic Latarjet procedure can provide satisfactory outcomes in terms of recurrence rate, range of motion and functional scores at minimum two years follow-up. The coracoid graft and the screws can be accurately placed. Low complication rate and high healing rate of the transferred coracoid are achieved after the modified Latarjet procedure.