Latarjet procedure: is the coracoid enough to restore the glenoid surface?

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.

Keywords: CT scan; Glenoid bone loss; Latarjet procedure; Shoulder instability.