Accuracy of Coracoid Bone Graft Placement: Open versus Arthroscopic Latarjet

Adriano Russo; Andrea Grasso; Annalisa Arrighi; Angela Pistorio; Luigi Molfetta

doi:10.1055/s-0037-1603934

Joints, Inhaltsverzeichnis

CC-BY-NC-ND 4.0 · Joints 2017; 05(02): 085-088
DOI: 10.1055/s-0037-1603934

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Accuracy of Coracoid Bone Graft Placement: Open versus Arthroscopic Latarjet

Adriano Russo

¹Department of Orthopaedics, Florence Institute of Assistance and Care (IFCA) Ulivella and Glicini Clinic, Florence, Italy

,

Andrea Grasso

²Department of Orthopaedics, Villa Valeria Clinic, Rome, Italy

,

Annalisa Arrighi

³School of Medical and Pharmaceutical Sciences, University of Genoa, Genoa, Italy

,

Angela Pistorio

⁴Department of Epidemiology and Biostatistics, Giannina Gaslini Institute, Genoa, Italy

,

Luigi Molfetta

⁵Research Center of Osteoporosis and Osteoarticular Diseases, University of Genoa, Genoa, Italy

› Institutsangaben

Abstract

Purpose The aim of this study was to compare the accuracy of the coracoid bone graft placement with the open Latarjet-Patte and arthroscopic Latarjet (arthro-Latarjet) procedures in the treatment of anterior instability of the shoulder.

Methods Forty-six patients affected by anterior shoulder instability were divided into two groups. In group A (n = 25), patients were operated by arthroscopic Latarjet (arthro-Latarjet) procedure and in group B (n = 21), patients were operated by open Latarjet-Patte procedure. Instrumental investigation was based on three-dimensional computed tomography (3D-CT) at a minimum 1-year follow-up. Graft placement and integration, divergence and posterior protrusion of the screws, and glenohumeral osteoarthritis were considered as outcomes. Statistical analysis was performed with chi-square or Fisher's exact test. Significance was set at p < 0.05.

Results Positioning of the coracoid graft proved to be optimal in 76% (19/25) of patients of group A and in 100% (21/21) of patients of group B (Fisher's exact test, p = 0.025). Screw placement with respect to the glenoid surface showed a posterior divergence in 44% (11/25) of patients in group A and in 24% (5/21) of patients in group B (p = 0.15). Posterior protrusion of screw was observed in 76% (19/25) of patients in group A and 71.4% (15/21) of patients in group B (p = 0.73). Graft integration was present in 76% (19/25) of patients in group A and 85.7% (18/21) of patients in group B (Fisher's exact test, p = 0.48). Mild signs of glenohumeral osteoarthritis were observed in 12% (3/25) of patients in group A and 28.6% (6/21) of patients in group B (Fisher's exact test, p = 0.26).

Conclusion Patients operated with open Latarjet-Patte procedure showed better results than those of the arthro-Latarjet group in reference to the positioning of the graft on the coronal plane (p = 0.025). No significant differences between the groups were observed for graft integration, divergence of the screws, posterior protrusion of the screws, and osteoarthritis.

Level of Evidence Level II, nonrandomized prospective comparative study.

Keywords

arthroscopic - coracoid graft - instability - Latarjet-Patte - shoulder - computed tomography

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Referenzen

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