Clinical and radiographic outcomes using standard length of cannulated screws for traditional Latarjet procedure

Abstract

PurposeThe purpose of this study was to evaluate the clinical and radiographic outcomes of open traditional Latarjet stabilization using 32mm and 30mm long cannulated screws in males and females respectively with a minimum of 2 years’ follow-up. MethodsWe retrospectively reviewed open Latarjet procedures using cannulated screws of standard length with a minimum of 2 years follow-up. Functional evaluation was performed with postoperative Rowe and Walch score, visual analogue scale for pain (VAS) and return to sport. Graft healing was assessed with CT scans at 4 to 6 months postoperatively. Patients were divided into 2 groups according to postoperative radiographic measurements: a bicortical or unicortical screw groups. The α angle between the shaft of the screw and the glenoid subchondral bone was measured for superior and inferior screws. Level of significance was 0.05. The post hoc power analysis was 0.89. ResultsA total of 69 patients met the criteria for inclusion. Of these patients, 60 (87%) were available for final follow-up (n =62 shoulders), with a mean age of 28.4 ±9.5 years (range, 16-55 years) at time of surgery. 56 males (93.3%) and 4 females (6.7%) were included. The mean final follow-up period was a mean of 38 months after the procedure (range, 25-48 months). 8 out 60 patients (13.3%) had persistent apprehension in abduction–external rotation position. One patient (1.7%) had a recurrence of shoulder subluxation. The mean Walch-Duplay score was 90±11.6 points (range, 40-100 points), and the mean Rowe score was 93.4±11 points (range, 50-100 points). The mean VAS score for the evaluation of pain was 0.9±1.3 (range, 0-4). The coracoid healed the glenoid neck in 87.1% (54/62) of the shoulders on the postoperative CT scan. Lower alpha angle for inferior and superior screws had more rate of unicortical fixation (P=0.05 and P=0.04, respectively). 14 out 62 (22.6%) shoulders were found unicortical screws. Six bicortical cases and 2 cases unicortical screws (25%) showed nonunion (p=0.86). There were 2 complications, one patient had hematoma that required drainage, one case had transient axillary nerve palsy which resolved spontaneously. No complications associated with the hardware were found. ConclusionOpen traditional Latarjet procedure using 32 mm and 30mm long cannulated screws in male and females respectively, provided good outcomes with acceptable complication rates. Unicortical screws fixation does not have a higher rate of non-union than bicortical screws.