Summary

The all-arthroscopic endo-button Latarjet procedure is a technically challenging technique that provides acceptable absorption rate and graft positioning.

Abstract

Purpose

The arthroscopic Latarjet procedure is recently becoming an increasingly popular technique. Nevertheless, the position and absorption rate of the coracoid bone block had not been well studied yet, particularly in the all-arthroscopic endo-button Latarjet procedure. The purpose of this study was to assess the position of the coracoid graft and the absorption rate on CT scan in the all-arthroscopic endo-button Latarjet procedure.

Methods

The study design was a prospective series of 18 consecutive patients who received all-arthroscopic endo-button Latarjet procedure in our institute from Feb 2015 to Jan 2016. Radiological assessment on CT scan performed 1 day, 3 months, 6 months post-operatively included an analysis of the absorption and the position of the coracoid bone graft using a validated method. In the axial view, the bone block lateral edge and medial edge were measured on the 1 day, 3 months, 6 months post-operatively CT scan (congruent to the surface of the glenoid was positive, medial to the surface was minus) . In the oblique sagittal view, the bone block inferior edge and superior edge were also measured on CT scan at these 3 time points (congruent to the tangent line of the gleniod inferior margin was positive, superior to the tangent line was minus). Then, the absorption rate could be calculated.

Results

Among the 18 patients, there were 17 males, 1 female, 6 left shoulders, 12 right shoulders. The average age of patients was 27.7±6.0. The center of the coracoid graft were positioned at 4:13h (126.3°±13.4° ). In the axial view, the medial to lateral direction absorption rate of the coracoid graft were 10.7%±15.5%, 19.7%±24.8%, at 3 months and 6 months post-operatively, respectively. And in the oblique sagittal view, the superior to inferior direction absorption rate of the bone block were 11.6%±14.3%, 22.8%±23.0%, at 3 months and 6 months post-operatively, respectively.

Conclusion

The all-arthroscopic endo-button Latarjet procedure is a technically challenging technique that provides acceptable absorption rate and graft positioning. 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 all-arthroscopic endo-button Latarjet according to a detailed and validated method.

Keywords: Shoulder arthroscopy, Latarjet, Bone graft positioning, Bone absorption, CT scan, Instability, Dislocation