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Open AccessArticle

Relationship between the Thickness of the Coracoid Process and Latarjet Graft Positioning—An Anatomical Study on 70 Embalmed Scapulae

1
Department of Orthopedics and Trauma-Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
2
Department of Orthopedics and Trauma-Surgery, Krankenhaus der Barmherzigen Brüder Eisenstadt, Johannes von Gott-Platz 1, 7000 Eisenstadt, Austria
3
Center for Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna, Währinger Straße 13, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 207; https://doi.org/10.3390/jcm9010207
Received: 10 December 2019 / Revised: 7 January 2020 / Accepted: 9 January 2020 / Published: 12 January 2020
(This article belongs to the Special Issue Orthopaedics: Medicine and Mechanisms)
Background: The Latarjet procedure is a popular technique with the aim of the reconstruction of glenoid cavity bone defects in patients with chronic anterior shoulder instability. Studies have shown that the Congruent arc Latarjet procedure is better able to reconstruct larger defects than the Classic Latarjet, but there is a lack of information on the limitations of both methods. Methods: The dimensions of the glenoid width and the native coracoid process of two groups with 35 Formol-Carbol embalmed scapulae each were measured using a digital caliper. The relationship between the coracoid graft and the anterior-posterior diameter of the glenoid cavity was calculated to determine the maximum defect size of the glenoid cavity width, which can be treated by both Latarjet techniques. Results: The average restorable defect size of the anterior segment of the glenoid cavity was 28.4% ± 4.6% (range 19.2%–38.8%) in the Classic Latarjet group, and 45.6% ± 5.2% (range 35.7%–57.1%) in the Congruent arc Latarjet group. Based on our results, the feasibility of the Classic Latarjet procedure to reconstitute the anatomical width of the glenoid cavity was 86% in a 25% bone loss scenario, and only 40% in a 30% bone loss scenario. Conclusion: Based on our results we are unable to define a clear threshold for the optimal Latarjet graft position. In glenoid cavity defects <20%, the Classic Latarjet technique usually provides enough bone stock for anatomical reconstruction. Defects ≥35% of the glenoid cavity width should only be treated with a coracoid graft in the Congruent arc position. In the critical area between 20% and 35% of bone loss, we suggest the preoperative assessment of coracoid dimensions, based on which the graft position can be planned to restore the anatomical anterior-posterior diameter of the glenoid cavity. View Full-Text
Keywords: shoulder; instability; Latarjet; glenoid; bone defect; graft position shoulder; instability; Latarjet; glenoid; bone defect; graft position
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MDPI and ACS Style

Gregori, M.; Eichelberger, L.; Gahleitner, C.; Hajdu, S.; Pretterklieber, M. Relationship between the Thickness of the Coracoid Process and Latarjet Graft Positioning—An Anatomical Study on 70 Embalmed Scapulae. J. Clin. Med. 2020, 9, 207.

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