2017 ISAKOS Biennial Congress ePoster #2003

 

Modified Arthroscopic Latarjet Procedure: A Chinese Experience

Wei Lu, MD, PhD, Prof., Shenzhen, Guangdong CHINA
Daping Wang, Shenzhen, Quong Dong Province CHINA
Weimin Zhu, MD, Shenzhen, Guangdong CHINA
Kan Ouyang, Shenzhen CHINA
Liangquan Peng, MD, Shenzhen CHINA
Haifeng Liu, Shenzhen, Guangdong CHINA
Hao Li, MD, Shenzhen, Guangdong CHINA
Wenzhe Feng, master of medicine, Shenzhen CHINA
Jian Xu, PhD, Shenzhen, Guangdong CHINA
Mingjin Zhong, MD, Shenzhen City, guangzhong province CHINA

Shenzhen second people's hospital; Shenzhen 1st affiliated hospital, Shenzhen, Guangdong, CHINA

FDA Status Cleared

Summary

We report a case series of modified arthroscopic Latarjet procedure, thus to provide suggestions for the surgeons.

Abstract

Purpose

To report on the intraoperative and early postoperative (<12 months) outcomes encountered with the arthroscopic Latarjet procedure in patients with anterior shoulder instability with large bone loss.

Methods

Between Oct,2014 and May, 2016, 36 patients underwent an modified arthroscopic Latarjet procedure for recurrent anterior instability with large bone loss. The group’s mean age was 24 to 31 years and consisted of 33 (92%) left shoulders. The bone loss ratio was 21.8% in average. The coracoid process was harvest first through the 2.5cm skin incision. Arthroscopically, the subscapular tendon was split and a double-tube-guide was used to drill the 4.5mm glenoid tunnel, a paired endobutton were used to fix the bone graft on glenoid.Radiological assessment on CT scan performed 3 months post-operatively included an analysis of the fusion and the position of the coracoid bone graft using a validated method. 02:30-04:20 was considered an ideal positioning in the sagittal view. In the axial view, the positioning was considered as flush, congruent, medial, too medial, or lateral.

Results

At a mean follow-up of 8.2 months (range, 3 to 24 months), 32 cases had good graft position.The median age of patients was 23.3±5.3. Mean operative time was of 102 ±22.3min. Coracoid grafts were positioned 02:22 h to 5:34 h. In the axial view, 30 % of the grafts positioning were considered as flush, 28 % as congruent, 20 % as medial, and 2 % too medial, 20% too lateral position was noted. The fusion rate was of 35/36(97%)%.No graft fracture, nerve injury occurred. One un-union case was observed and needed secondary operative procedure.

Conclusions

The double paired endobutton modified arthroscopic latarjet procedure is time savage, simple, and reproducible with fewer adverse events comparing to the reported with the traditional arthroscopic Latarjet procedure. With appropriate training, the arthroscopic Latarjet procedure can be effective for the management of patients with complex shoulder instability.