An assessment of the clinical relevance of coracoid graft osteolysis following the Latarjet procedure : a clinical and radiological review

Crown Copyright © 2024 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 8(2024), 4 vom: 04. Juli, Seite 719-723
1. Verfasser: Ting, Ryan S (VerfasserIn)
Weitere Verfasser: Jang, Bob, Murray, Nicholas, Williams, Tiffany G, Kang, Isabella L, Su, Yon, Nguyen, Tam Anh, Ridley, William E, Manowski, Blake R, Caudwell, Michelle, Martin, Linda, Trantalis, John N
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2024
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Bone block Coracoid Dislocation Instability Latarjet Osteolysis Resorption Shoulder
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520 |a Background: The Latarjet procedure was developed for the treatment of anterior shoulder instability in young, high-demand patients with attritional glenoid bone loss, whose risk of redislocation following primary dislocation may exceed 90%. Coracoid graft osteolysis and prominent screws are commonly observed in late computed tomography (CT) scans of patients who re-present following the procedure, but the clinical relevance of osteolysis in the overall Latarjet cohort is undetermined. We aimed to evaluate clinical and radiological outcomes in patients who underwent the Latarjet procedure, and to determine if severe coracoid graft osteolysis compromised clinical outcomes 
520 |a Methods: This was a retrospective analysis of patients who underwent the open Latarjet procedure. Patients were invited via an e-questionnaire that contained a Western Ontario Shoulder Instability Index (WOSI), and queried about redislocation and reoperation since index surgery. Preoperative glenoid bone loss was calculated on CT using the best-fit circle method. Osteolysis was graded (0, screw head buried in graft; 1, screw head exposed; 2, threads exposed; 3, complete resorption/severe osteolysis) at the level of the proximal and distal screws respectively, on axial CT scans performed ≥ 12 months postoperatively 
520 |a Results: Between 2011 and 2022, a single surgeon performed 442 Latarjet procedures. One hundred fifty eight patients responded to the questionnaire at median (interquartile range [IQR]) 44 (27-70) months postoperatively, among whom the median (IQR) WOSI score was 352 (142-666) points (0 = best, 2100 = worst). Recurrent anterior instability occurred in 3/158 (2%) patients. One patient required reoperation for this indication. Among patients who had CT scans ≥ 12 months postoperatively (median [IQR] 40 [29-69] months), 1 patient developed severe osteolysis around both screws (WOSI = 90), 17/62 (27%) patients developed severe osteolysis around 1 screw, all of which were proximal (median [IQR] WOSI = 235 [135-644]), and 44/62 (71%) patients did not develop severe osteolysis around either screw (median [IQR] WOSI = 487 [177-815]). There were no statistically significant differences in WOSI scores between groups based on the presence of severe osteolysis 
520 |a Conclusion: The Latarjet is reliable procedure that has a low rate of redislocation and reoperation. Severe coracoid graft osteolysis occurs with time, and always affects the proximal graft first. The presence of severe osteolysis did not compromise clinical outcomes 
650 4 |a Journal Article 
650 4 |a Bone block 
650 4 |a Coracoid 
650 4 |a Dislocation 
650 4 |a Instability 
650 4 |a Latarjet 
650 4 |a Osteolysis 
650 4 |a Resorption 
650 4 |a Shoulder 
700 1 |a Jang, Bob  |e verfasserin  |4 aut 
700 1 |a Murray, Nicholas  |e verfasserin  |4 aut 
700 1 |a Williams, Tiffany G  |e verfasserin  |4 aut 
700 1 |a Kang, Isabella L  |e verfasserin  |4 aut 
700 1 |a Su, Yon  |e verfasserin  |4 aut 
700 1 |a Nguyen, Tam Anh  |e verfasserin  |4 aut 
700 1 |a Ridley, William E  |e verfasserin  |4 aut 
700 1 |a Manowski, Blake R  |e verfasserin  |4 aut 
700 1 |a Caudwell, Michelle  |e verfasserin  |4 aut 
700 1 |a Martin, Linda  |e verfasserin  |4 aut 
700 1 |a Trantalis, John N  |e verfasserin  |4 aut 
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