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. 2021 Jan;29(1):136-142.
doi: 10.1007/s00167-019-05830-7. Epub 2020 Jan 1.

Arthroscopic double-button Latarjet: two-thirds of bone block healed at 90 days

Yoann Dalmas  1 , Charles Edouard Thélu  2 , Pierre Laumonerie  1 , Mathieu Girard  1 , Marie Faruch  3 , Nicolas Bonnevialle  4   5
Affiliations

Arthroscopic double-button Latarjet: two-thirds of bone block healed at 90 days

Yoann Dalmas et al. Knee Surg Sports Traumatol Arthrosc. 2021 Jan.

Abstract

Purpose: The aim of this study was to evaluate the union rate and risk factors for delayed union in the early postoperative period after an arthroscopic Latarjet with double-button fixation.

Method: In a retrospective study, postoperative CT scans at 3 months were analysed following an arthroscopic Latarjet with double-button fixation used to treat anterior shoulder instability. Healing of the bone block, its position in the sagittal and coronal planes, and the contact area graft/scapula were analysed.

Results: Ninety-eight CT scans (98 patients) were included. The rate of healing at 3 months was 63/98 (64%) and four grafts clearly migrated. The position was perfectly flush to the glenoid rim in 67% and under the equator in 96%. The mean contact graft/scapula area was 135 mm 2 (4-420). In multivariate analysis, the risk of non-union at 3 months was associated with tobacco consumption (p = 0.001, aOR = 12.17 95% CI [2.62-56.49]), absence of preoperative glenoid bone defect (p = 0.003, aOR = 8.06 95% CI [2.06-31.56]), and a contact area graft/scapula less than 120 mm 2 (p = 0.010, aOR = 5.25 95% CI [1.50-18.40]). Among 31 non-united grafts, 93% definitively healed on CT scan at 1 year, leaving an overall rate of 93% of united grafts at last follow-up.

Conclusions: The rate of union at 3 months after an arthroscopic Latarjet with double-button fixation was 64%, reaching 93% at 1 year. This procedure should be carefully indicated in case of tobacco use or instability without glenoid bone defect, especially when the shoulder is exposed to high-energy trauma in the early phase after surgery.

Keywords: Arthroscopic; Bone block; CT scan; Double button; Latarjet; Non-union; Risk factors; Shoulder instability; Tobacco.

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