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Abstract

Background

Coracoid graft osteolysis is a known complication following the Latarjet procedure and may influence postoperative shoulder stability. While prior studies have reported variable rates of graft osteolysis, the risk factors that influence this process are not well defined. Therefore, the purpose of this systematic review was to investigate the risk factors associated with coracoid graft osteolysis after the Latarjet procedure. We hypothesized that the location of coracoid graft placement on the glenoid would influence graft osteolysis.

Methods

This review followed PRISMA guidelines to query the Medline, Embase, and Cochrane online databases. Eligible studies included prospective or retrospective clinical studies, including cohort studies, comparative studies, and case series, reporting postoperative graft osteolysis assessed by computerized tomography (CT) after the Latarjet procedure. A qualitative analysis was performed.

Results

Fifteen studies met the criteria to be included in this review, encompassing 963 patients. Of the four studies that assessed open vs arthroscopic Latarjet, open Latarjet was associated with increased rates of graft osteolysis in 3 of the 4 of studies (214 of 262 patients). There was an inverse relationship found between preoperative glenoid bone loss and graft osteolysis in 3 of 6 studies (256 of 382 patients), and there were no relationships observed between graft osteolysis and graft position, fixation type, or patient demographics. One of six studies that assessed osteolysis impact on clinical outcomes found lower Walch-Duplay scores as well as recurrent instability, while all other studies found no relationships noted between graft osteolysis and patient-reported outcome measures (PROMs), range of motion, or strength.

Discussion and conclusion

Coracoid graft osteolysis after the Latarjet procedure appears to be influenced by surgical technique (open vs arthroscopic) and preoperative glenoid bone loss, with the arthroscopic technique and increased preoperative glenoid bone loss showing reduced graft osteolysis in some studies. However, most studies demonstrated no significant association between graft osteolysis and clinical outcomes, with contrary findings limited to small, underpowered cohorts.

Level of Evidence

Keywords

Latarjet coracoid graft osteolysis shoulder instability glenoid bone loss graft position shoulder range of motion

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References

Owens

Dickens

. Shoulder Instability in the Athlete: Management and Surgical Techniques for Optimized Return to Play. 1st ed. Boca Raton: CRC Press. 2024. DOI: 10.1201/9781003526391.

Varacallo

Musto

Mair

. Anterior Shoulder Instability. In: StatPearls. Treasure Island (FL): StatPearls Publishing, http://www.ncbi.nlm.nih.gov/books/NBK538234/ (2025, accessed 19 June 2025).

Shaha

Cook

Song

, et al. Redefining “critical” bone loss in shoulder instability. Am J Sports Med 2015; 43: 1719–1725.

Tokish

. Arthroscopic distal clavicle glenoid augmentation: an ideal graft option. Oper Tech Sports Med 2019; 27: 89–94.

Domos

Lunini

Walch

. Contraindications and complications of the latarjet procedure. Shoulder Elbow 2018; 10: 15–24.

Jackson

Brusalis

Schundler

, et al. Isolated primary latarjet procedures for anterior shoulder instability results in high rates of graft resorption and glenohumeral degenerative changes with low rates of failure at a Minimum 2-year follow-up: a systematic review. Arthroscopy 2024; 40: 581–591.e1.

Cohen

Zaluski

Siqueira

GdL

, et al. Risk factors for coracoid graft osteolysis after the open latarjet procedure. Rev Bras Ortop (Sao Paulo) 2020; 55: 585–590.

Sahu

Shah

Shetty

. Coracoid graft resorption after the latarjet procedure does not depend on the preoperative glenoid defect. J Shoulder Elbow Surg 2023; 32: e94–e105.

Gupta

Delaney

Petkin

, et al. Complications of the latarjet procedure. Curr Rev Musculoskelet Med 2015; 8: 59–66.

10.

Wang

Zhou

Zhang

, et al. Early follow-up of arthroscopic latarjet procedure with screw or suture-button fixation for recurrent anterior shoulder instability. Orthop Surg 2020; 12: 1350–1361.

11.

Zhu

Jiang

Song

. Arthroscopic versus open latarjet in the treatment of recurrent anterior shoulder dislocation with marked glenoid bone loss: a prospective comparative study. Am J Sports Med 2017; 45: 1645–1653.

12.

Zhu

Y-M

Jiang

C-Y

, et al. Coracoid bone graft resorption after latarjet procedure is underestimated: a new classification system and a clinical review with computed tomography evaluation. J Shoulder Elbow Surg 2015; 24: 1782–1788.

13.

Ali

Altintas

Pulatkan

, et al. Open versus arthroscopic latarjet procedure for the treatment of chronic anterior glenohumeral instability with glenoid bone loss. Arthroscopy 2020; 36: 940–949.

14.

Balestro

J-C

Young

Maccioni

, et al. Graft osteolysis and recurrent instability after the latarjet procedure performed with bioabsorbable screw fixation. J Shoulder Elbow Surg 2015; 24: 711–718.

15.

Barret

Chelli

Van Der Meijden

, et al. Arthroscopic latarjet: 2 or 4 cortical buttons for coracoid fixation? A case-control comparative study. Am J Sports Med 2022; 50: 311–320.

16.

Casabianca

Gerometta

Massein

, et al. Graft position and fusion rate following arthroscopic latarjet. Knee Surg Sports Traumatol Arthrosc 2016; 24: 507–512.

17.

Dalmas

Thélu

C-E

Laumonerie

, et al. Arthroscopic double-button latarjet osteolysis and remodeling at 1-year follow-up. J Shoulder Elbow Surg 2022; 31: e603–e612.

18.

Delgado

Calvo

Díaz Heredia

, et al. Graft position, healing, and resorption in anterior glenohumeral instability: a comparison of 4 glenoid augmentation techniques. Orthop J Sports Med 2024; 12: 23259671241253163.

19.

Di Giacomo

De Gasperis

Costantini

, et al. Does the presence of glenoid bone loss influence coracoid bone graft osteolysis after the latarjet procedure? A computed tomography scan study in 2 groups of patients with and without glenoid bone loss. J Shoulder Elbow Surg 2014; 23: 514–518.

20.

Di Giacomo

Peebles

Midtgaard

, et al. Risk factors for recurrent anterior glenohumeral instability and clinical failure following primary latarjet procedures. J Bone Joint Surg Am 2020; 102: 1665–1671.

21.

Ernstbrunner

Francis-Pester

Waltenspül

, et al. The latarjet procedure in patients with subcritical glenoid bone loss: long-term results and its association with graft resorption. Orthop J Sports Med 2025; 13: 23259671251356265.

22.

Kordasiewicz

Kicinski

Małachowski

, et al. Comparative study of open and arthroscopic coracoid transfer for shoulder anterior instability (latarjet)—computed tomography evaluation at a short term follow-up. Part II. Int Orthop 2018; 42: 1119–1128.

23.

Albizzini Ohin

Guarrella

Perfetti

, et al. CT-scan Evaluation of osteointegration and osteolysis in different graft types and surgical techniques for the treatment of shoulder instability. Arch Bone Jt Surg 2023; 11: 117–123.

24.

Cohen

Zaluski

Siqueira

GSDL

, et al. Risk factors for coracoid graft osteolysis after the open latarjet procedure. Rev Bras Ortop (Sao Paulo) 2020; 55: 585–590.

25.

Hurley

Lim Fat

Farrington

, et al. Open versus arthroscopic latarjet procedure for anterior shoulder instability: a systematic review and meta-analysis. Am J Sports Med 2019; 47: 1248–1253.

26.

Rowe

Koller

Sharma

. Physiology, bone remodeling. In: StatPearls. Treasure Island (FL): StatPearls Publishing, http://www.ncbi.nlm.nih.gov/books/NBK499863/ (2025, accessed 19 June 2025).

27.

Cirino

Jahandar

Kontaxis

, et al. The effect of concavity restoration on glenohumeral stability in a glenoid bone loss model: comparing the distal tibial allograft reconstruction and the latarjet procedure. Orthop J Sports Med 2024; 12: 2325967124S00012.

28.

Galvin

Zimmer

Prete

, et al. The open eden-hybinette procedure for recurrent anterior shoulder instability with glenoid bone loss. Oper Tech Sports Med 2019; 27: 95–101.

29.

Ganokroj

Dey Hazra

R-O

, et al. Biomechanical evaluation of the 2 different levels of coracoid graft positions in the latarjet procedure for anterior shoulder instability. Orthop J Sports Med 2023; 11: 23259671231202533.

30.

Martins

Quental

Folgado

, et al. Influence of graft positioning during the latarjet procedure on shoulder stability and articular contact pressure: computational analysis of the bone block effect. Biology (Basel) 2022; 11: 1783.

Predictors of coracoid graft osteolysis after the Latarjet procedure: A systematic review