Artikel
Open versus arthroscopic Latarjet procedure: accuracy of the coracoid placement in a cadaver study
Suche in Medline nach
Autoren
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Rupert Meller
- Medizinische Hochschule Hannover, Unfallchirurgische Klinik, Hannover, Germany
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Nael Hawi
- Medizinische Hochschule Hannover, Unfallchirurgische Klinik, Hannover, Germany
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Emmanouil Liodakis
- Medizinische Hochschule Hannover, Klinik für Unfallchirurgie, Hannover, Germany
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Christian Krettek
- Medizinische Hochschule Hannover, Unfallchirurgische Klinik, Hannover, Germany
| Veröffentlicht: | 23. Oktober 2017 |
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Gliederung
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Objectives: Correct positioning of the coracoid graft is crucial for the success of an open or arthroscopic Latarjet procedure. The purpose of the present study was to test whether the placement accuracy of the coracoid graft in the arthroscopic Latarjet technique would be comparable to that of the open technique.
Methods: Eighteen upper extremities of 9 whole fresh cadavers were used in this study. For each cadaver, one shoulder was operated open and the contralateral shoulder in the arthroscopic technique. The site and the procedure to begin with were randomized. The open procedure was performed according to the technique of Walch, the arthroscopic technique according to the technique of Lafosse. Following an intraoperative assessment of the position of the graft, a postoperative computed tomography (CT) was performed to exactly measure the position of the graft. According to computed measurements, the positioning of the grafts was grouped in 3 categories to detect different patterns of malpositioning (Type I: optimal position, Type II: acceptable but not optimal position, Type III: unacceptable position).
Results: The CT evaluation showed no differences between the arthroscopic and the open Latarjet procedure (p=0.853). Sixteen specimens had a type I placement of the graft (8 arthroscopic, 8 open), two had a type II placements (1 arthroscopic, 1 open) and none of the shoulders demonstrated a type III placement. The intraoperative assessment had a good agreement with the postoperative CT evaluation (15 out of 18, 83.3% agreement level).
Conclusion: Both techniques (open and arthroscopic) allow for an accurate placement of the coracoid graft. The proposed evaluation system is a new tool for quantification of the position of the coracoid. Type I shoulders are the most common types after coracoid transfer, regardless of the technique used (open or arthroscopic).
Clinical Relevance: Both, the arthroscopic and the open technique for the Latarjet procedure allow an equally good placement of the coracoid graft.
