Paolo Paladini1, Rohit Singla2, Giovanni Merolla3, Giuseppe Porcellini3. 1. Unit of Shoulder and Elbow Surgery-D. Cervesi Hospital, Via L.V. Beethoven 46, Cattolica, RN, Italy. palpaolo@me.com. 2. 321/1/19, Medicos Agencies, Opp. Civil Hospital, Rohtak, India. 3. Unit of Shoulder and Elbow Surgery-D. Cervesi Hospital, Via L.V. Beethoven 46, Cattolica, RN, Italy.
Abstract
PURPOSE: The aim of this study was to establish whether anterior glenoid bone loss in patients with large glenoid rim defects can be restored with a coracoid graft (Latarjet procedure). METHODS: A total of 143 consecutive patients with chronic anterior shoulder instability and glenoid bone deficiency were treated in 2013. A pre-operative computed tomography (CT) scan using the PICO method was obtained to estimate anterior glenoid rim erosion. The 23 patients with anterior glenoid deficiency exceeding 20 % were included in the study. A post-operative CT scan was obtained to establish whether coracoid transfer had fully restored the glenoid surface. RESULTS: Mean bone loss was 26 ± 3.9 % of the glenoid surface (range 20-34 %) compared with the contralateral glenoid. Mean coracoid dimensions were 26.3 ± 2.9 mm × 7.6 ± 0.65 mm. The graft successfully restored the glenoid surface in all patients (mean filling, 102.4 ± 0.8 %). DISCUSSION: The Latarjet procedure is a valuable approach to treat patients with chronic shoulder instability and glenoid deficiency. CONCLUSION: Coracoid transfer restored the glenoid surface even in patients with large defects. The Eden-Hybinette technique seems to be more appropriate for revision surgery and for patients with a failed Latarjet procedure.
PURPOSE: The aim of this study was to establish whether anterior glenoid bone loss in patients with large glenoid rim defects can be restored with a coracoid graft (Latarjet procedure). METHODS: A total of 143 consecutive patients with chronic anterior shoulder instability and glenoid bone deficiency were treated in 2013. A pre-operative computed tomography (CT) scan using the PICO method was obtained to estimate anterior glenoid rim erosion. The 23 patients with anterior glenoid deficiency exceeding 20 % were included in the study. A post-operative CT scan was obtained to establish whether coracoid transfer had fully restored the glenoid surface. RESULTS: Mean bone loss was 26 ± 3.9 % of the glenoid surface (range 20-34 %) compared with the contralateral glenoid. Mean coracoid dimensions were 26.3 ± 2.9 mm × 7.6 ± 0.65 mm. The graft successfully restored the glenoid surface in all patients (mean filling, 102.4 ± 0.8 %). DISCUSSION: The Latarjet procedure is a valuable approach to treat patients with chronic shoulder instability and glenoid deficiency. CONCLUSION: Coracoid transfer restored the glenoid surface even in patients with large defects. The Eden-Hybinette technique seems to be more appropriate for revision surgery and for patients with a failed Latarjet procedure.
Entities:
Keywords:
CT scan; Glenoid bone loss; Latarjet procedure; Shoulder instability
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