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

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• 作者：Giovanni Di Giacomo ; MD^a ; ^{Concordia@iol.it" class="auth_mail} ; Nicola de Gasperis ; MD^a ; Alberto Costantini ; MD^a ; Andrea De Vita ; MD^a ; Mario A. Rojas Beccaglia ; MD^a ; Nicole Pouliart ; PhD^b
• 关键词：Level II ; Prospective Cohort Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：April, 2014
• 年：2014
• 卷：23
• 期：4
• 页码：514-518
• 全文大小：621 K

文摘

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Background

Coracoid bone graft osteolysis and fibrous union are the principal causes of failure in patients treated with the Latarjet procedure. This study aims to investigate the hypothesis that coracoid bone graft osteolysis is more pronounced in cases without glenoid bone loss, which may be due to a diminished mechanotransduction effect at the bone healing site.

Methods

We prospectively followed up 34 patients, treated with a mini-plate Latarjet procedure, divided into 2 groups (group A patients had glenoid bone loss >15% and group B patients had no glenoid bone loss). A computed tomography scan evaluation with 3-dimensional reconstruction was then performed on all patients to evaluate coracoid bone graft osteolysis according to our coracoid bone graft osteolysis classification.

Results

The computed tomography scan analysis showed a different distribution of osteolysis between group A and group B. The statistical analysis showed a significant difference (P < .01, Bonferroni test)聽between groups A and B for the following sections: proximal/lateral/superficial, proximal/medial/deep, distal/lateral/superficial, and distal/lateral/deep. On average, the coracoid grafts in group A patients showed less osteolysis than the coracoid grafts in group B patients (39.6% vs 65.1%).

Discussion

The coracoid bone graft underwent much less osteolysis in patients with significant glenoid bone loss (>15%) than in those without it. Because factors of blood supply, compression, and surgical technique were the same for both groups, we believe that the mechanotransduction effect from the humeral head on the graft influences its remodeling.

Conclusion

The results of this study suggest that the bone graft part of the Latarjet procedure plays a role in patients with significant coracoid bone loss but much less so when there is no bone loss.