Latarjet procedure: is the coracoid enough to restore the glenoid surface?

Abstract

The aim of this study was to establish whether anterior glenoid bone loss in patients with large glenoid rim defects can be restored with a coracoid graft (Latarjet procedure). A total of 143 consecutive patients with chronic anterior shoulder instability and glenoid bone deficiency were treated in 2013. A pre-operative computed tomography (CT) scan using the PICO method was obtained to estimate anterior glenoid rim erosion. The 23 patients with anterior glenoid deficiency exceeding 20% were included in the study. A post-operative CT scan was obtained to establish whether coracoid transfer had fully restored the glenoid surface. Mean bone loss was 26 ± 3.9% of the glenoid surface (range 20-34%) compared with the contralateral glenoid. Mean coracoid dimensions were 26.3 ± 2.9mm × 7.6 ± 0.65mm. The graft successfully restored the glenoid surface in all patients (mean filling, 102.4 ± 0.8%). The Latarjet procedure is a valuable approach to treat patients with chronic shoulder instability and glenoid deficiency. Coracoid transfer restored the glenoid surface even in patients with large defects. The Eden-Hybinette technique seems to be more appropriate for revision surgery and for patients with a failed Latarjet procedure.