Pascal Boileau1, Patrick Gendre2, Mohammed Baba2, Charles-Édouard Thélu2, Toby Baring2, Jean-François Gonzalez2, Christophe Trojani2. 1. Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France. Electronic address: boileau.p@chu-nice.fr. 2. Department of Orthopaedic Surgery and Sports Traumatology, Hôpital de L'Archet, Medical University of Nice-Sophia-Antipolis, Nice, France.
Abstract
BACKGROUND: Most of the complications of the Latarjet procedure are related to the bone block positioning and use of screws. The purpose of this study was to evaluate if an arthroscopic Latarjet guiding system improves accuracy of bone block positioning and if suture button fixation could be an alternative to screw fixation in allowing bone block healing and avoiding complications. MATERIALS AND METHODS: Seventy-six patients (mean age, 27 years) underwent an arthroscopic Latarjet procedure with a guided surgical approach and suture button fixation. Bone graft union and positioning accuracy were assessed by postoperative computed tomography imaging. Clinical examinations were performed at each visit. RESULTS: At a mean of 14 months (range, 6-24 months) postoperatively, 75 of 76 patients had a stable shoulder. No neurologic complications were observed; no patients have required further surgery. The coracoid graft was positioned strictly tangential to the glenoid surface in 96% of the cases and below the equator in 93%. The coracoid graft healed in 69 patients (91%). CONCLUSIONS: A guided surgical approach optimizes graft positioning accuracy. Suture button fixation can be an alternative to screw fixation, obtaining an excellent rate of bone union. Neurologic and hardware complications, classically reported with screw fixation, have not been observed with this guided technique and novel fixation method.
BACKGROUND: Most of the complications of the Latarjet procedure are related to the bone block positioning and use of screws. The purpose of this study was to evaluate if an arthroscopic Latarjet guiding system improves accuracy of bone block positioning and if suture button fixation could be an alternative to screw fixation in allowing bone block healing and avoiding complications. MATERIALS AND METHODS: Seventy-six patients (mean age, 27 years) underwent an arthroscopic Latarjet procedure with a guided surgical approach and suture button fixation. Bone graft union and positioning accuracy were assessed by postoperative computed tomography imaging. Clinical examinations were performed at each visit. RESULTS: At a mean of 14 months (range, 6-24 months) postoperatively, 75 of 76 patients had a stable shoulder. No neurologic complications were observed; no patients have required further surgery. The coracoid graft was positioned strictly tangential to the glenoid surface in 96% of the cases and below the equator in 93%. The coracoid graft healed in 69 patients (91%). CONCLUSIONS: A guided surgical approach optimizes graft positioning accuracy. Suture button fixation can be an alternative to screw fixation, obtaining an excellent rate of bone union. Neurologic and hardware complications, classically reported with screw fixation, have not been observed with this guided technique and novel fixation method.
Authors: Bartłomiej Kordasiewicz; Maciej Kicinski; Konrad Małachowski; Janusz Wieczorek; Sławomir Chaberek; Stanisław Pomianowski Journal: Int Orthop Date: 2018-01-04 Impact factor: 3.075
Authors: Bartłomiej Kordasiewicz; Konrad Małachowski; Maciej Kicinski; Sławomir Chaberek; Stanisław Pomianowski Journal: Int Orthop Date: 2016-12-30 Impact factor: 3.075