Quantitative Assessment of the Latarjet Procedure for Large Glenoid Defects by Computed Tomography

Abstract

Background:

Coracoid transfer to a large glenoid defect is considered an excellent method to restore the surface area of the anteroinferior glenoid. However, there is little quantitative evidence supporting whether a coracoid graft can sufficiently restore the glenoid arc.

Purpose:

To assess whether the Latarjet procedure can sufficiently restore the surface area of the glenoid.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 44 patients who underwent a Latarjet operation for a large glenoid defect between February 2009 and July 2011 were enrolled in this study. Three-dimensional computed tomography was used to calculate the surface areas of the preoperative glenoid defect size and the reconstructed glenoid. Preoperative and postoperative clinical results also were assessed.

Results:

At the last follow-up, the mean visual analog scale score for instability during motion improved significantly from 5.1 points (range, 3-10 points) preoperatively to 1.3 points (range, 0-4 points) (P < .001). The mean deficit in external rotation at the side, external rotation at 90° of abduction, and internal rotation to the posterior were 10° ± 20°, 7° ± 16°, and 1.9° ± 4°, respectively (P = .004, .022, and .009, respectively). The overall recurrence rate was 4.5% (2 of 44 shoulders). The mean preoperative glenoid defect size was 157 ± 38 mm² (range, 141-239 mm²; 25.3% ± 6% of the intact glenoid surface). The mean surface area of the coracoid graft used for reconstruction was 152 ± 34 mm² (range, 146-236 mm²; 24.8% ± 5% of the intact glenoid surface). After the Latarjet procedure, the mean surface area of the reconstructed glenoid was 706 ± 32 mm² (range, 639-749 mm²). Finally, postoperative glenoid defect size was 5 ± 11 mm² (range, 3-28 mm²; 1.5% ± 2% of the intact glenoid surface).

Conclusion:

The Latarjet procedure can provide satisfactory outcomes, including a low recurrence rate and reliable functional recovery. Defects at the anteroinferior glenoid were restored to nearly normal after coracoid transfer by use of the Latarjet procedure, which is an anatomically matched reconstruction.