Radiographic study of effect of lateral placement of bone graft on shoulder joint degeneration after modified arthroscopic Latarjet surgery with elastic fixation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

QIN Qihuang ^1,2 , LIANG Xinzhi ¹ , LIANG Daqiang ¹ , DENG Zhenhan ¹ , QIU Zhihe ¹ , LI Sheng ¹ , WU Bing ¹ , LI Ying ¹ , LI Hao ¹ ,  LIU Haifeng ¹ ,  LU Wei ^1,2

1. Department of Sports Medicine, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People’s Hospital), Shenzhen Guangdong, 518000, P.R.China;
2. Shantou University Medical College, Shantou Guangdong, 515041, P.R.China;

Corresponding author：

LIU Haifeng, Email: 819811255@qq.com; LU Wei, Email: 13922855513@139.com

Keywords：

Recurrent anterior shoulder dislocation; modified Latarjet surgery; arthroscopy; elastic fixation; shoulder joint degeneration

DOI：

10.7507/1002-1892.202011089

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Objective To investigate the mid-term effect of lateral placement of bone graft on shoulder joint degeneration after modified arthroscopic Latarjet surgery with elastic fixation for recurrent anterior shoulder dislocation with an anterior glenoid bone defect.Methods According to the inclusion and exclusion criteria, 18 patients with recurrent anterior shoulder dislocation and anterior glenoid bone defect who received the modified arthroscopic Latarjet surgery with elastic fixation between January 2015 and November 2016 were enrolled in this study. There were 12 males and 6 females with an average age of 26.2 years (range, 19-37 years). The number of shoulder dislocation ranged from 4 to 30 times (mean, 8.8 times). The disease duration was 8-49 months (mean, 23.8 months). The mean anterior glenoid bone defect was 25.2% of the glenoid surface (range, 20%-29%). The mean preoperative Instability Severity Index Score (ISIS) was 7.6 (range, 7-10). According to Samilson-Prieto classification, the shoulder joint degeneration was rated as grade 0 in 13 cases, grade Ⅰ in 3 cases, and grade Ⅱ in 2 cases. Before and after operation, the visual analogue scale (VAS) score, American Society of Shoulder and Elbow Surgery (ASES) score, Walch-Duplay score, Rowe score, and shoulder mobility were used to evaluate the effectiveness. Imaging examination was performed to observe the shoulder joint degeneration, the position of the bone graft, and the postoperative shaping of the scapular glenoid.Results All patients were followed up 55-62 months, with an average of 59.6 months. There was no neurovascular injuries, infections, fixation-related and bone graft-related complications. No re-dislocation and revision occurred. All patients returned to normal life, 17 of whom returned to sport. The VAS score was significantly decreased and ASES, Walch-Duplay, and Rowe scores were significantly improved at last follow-up (P<0.05). No significant difference was found in range of motion of forward flexion, abduction, lateral rotation at 90° abduction, internal rotation at 90° abduction, or lateral rotation at 0° between pre- and post-operation (P>0.05). Three-dimensional CT showed that the centers of all bone grafts were between 3∶30 and 4∶30 (right shoulder) or between 7∶40 and 8∶20 (left shoulder) and no bone grafts were positioned superiorly or inferiorly in the glenoid En-face view. All bone grafts were positioned lateral to the scapular glenoid with an average distance of 3.5 mm (range, 2.3-4.6 mm) in cross-sectional imaging by CT. Compared with the preoperative Samilson-Prieto classification results, all cases showed no progression of shoulder joint degeneration at 36, 48 months and last follow-up. All bone grafts remodeled to a steady state within 24 months after operation. The bone graft and glenoid finally remodeled analogous to the shape of the intact glenoid in the En-face view and became flush with the glenoid rim, remodeling to a curved shape congruent to the humeral head in cross-sectional imaging by CT. The shape of the remodeled glenoid at last follow-up was not significantly different from that at 24 months after operation.Conclusion The lateral placement of the bone graft during modified arthroscopic Latarjet surgery with elastic fixation do not accelerate the imaging changes of shoulder joint degeneration.

Citation： QIN Qihuang, LIANG Xinzhi, LIANG Daqiang, DENG Zhenhan, QIU Zhihe, LI Sheng, WU Bing, LI Ying, LI Hao, LIU Haifeng, LU Wei. Radiographic study of effect of lateral placement of bone graft on shoulder joint degeneration after modified arthroscopic Latarjet surgery with elastic fixation. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(4): 414-419. doi: 10.7507/1002-1892.202011089 Copy

1.	Hurley ET, Montgomery C, Jamal MS, et al. Return to play after the Latarjet procedure for anterior shoulder instability: a systematic review. Am J Sports Med, 2019, 47(12): 3002-3008.
2.	Hurley ET, Jamal MS, Ali ZS, et al. Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies at 10-year follow-up. J Shoulder Elbow Surg, 2019, 28(2): e33-e39.
3.	Gilat R, Lavoie-Gagne O, Haunschild ED, et al. Outcomes of the Latarjet procedure with minimum 5- and 10-year follow-up: A systematic review. Shoulder Elbow, 2020, 12(5): 315-329.
4.	Kee YM, Kim HJ, Kim JY, et al. Glenohumeral arthritis after Latarjet procedure: Progression and it’s clinical significance. J Orthop Sci, 2017, 22(5): 846-851.
5.	Vezeridis PS, Ishmael CR, Jones KJ, et al. Glenohumeral dislocation arthropathy: etiology, diagnosis, and management. J Am Acad Orthop Surg, 2019, 27(7): 227-235.
6.	Filho JG, Leite MC, Borges ACW, et al. Clinical and radiographic evaluation of patients operated by the Bristow-Latarjet technique with a minimum follow-up of 20 years. Rev Bras Ortop (Sao Paulo), 2020, 55(4): 455-462.
7.	Allain J, Goutallier D, Glorion C. Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg (Am), 1998, 80(6): 841-852.
8.	Balestro JC, Young A, Maccioni C, et al. Graft osteolysis and recurrent instability after the Latarjet procedure performed with bioabsorbable screw fixation. J Shoulder Elbow Surg, 2015, 24(5): 711-718.
9.	Hovelius L, Sandström B, Saebö M. One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study Ⅱ-the evolution of dislocation arthropathy. J Shoulder Elbow Surg, 2006, 15(3): 279-289.
10.	Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg, 2016, 25(1): 78-89.
11.	Xu J, Liu H, Lu W, et al. Clinical outcomes and radiologic assessment of a modified suture button arthroscopic Latarjet procedure. BMC Musculoskelet Disord, 2019, 20(1): 173.
12.	Xu J, Liu H, Lu W, et al. Modified arthroscopic Latarjet procedure: suture-button fixation achieves excellent remodeling at 3-year follow-up. Am J Sports Med, 2020, 48(1): 39-47.
13.	Boileau P, Saliken D, Gendre P, et al. Arthroscopic Latarjet: suture-button fixation is a safe and reliable alternative to screw fixation. Arthroscopy, 2019, 35(4): 1050-1061.
14.	Samilson RL, Prieto V. Dislocation arthropathy of the shoulder. J Bone Joint Surg (Am), 1983, 65(4): 456-460.
15.	Lafosse L, Boyle S, Gutierrez-Aramberri M, et al. Arthroscopic latarjet procedure. Orthop Clin North Am, 2010, 41(3): 393-405.
16.	Samim M, Small KM, Higgins LD. Coracoid graft union: a quantitative assessment by computed tomography in primary and revision Latarjet procedure. J Shoulder Elbow Surg, 2018, 27(8): 1475-1482.
17.	Lädermann A, Lubbeke A, Stern R, et al. Risk factors for dislocation arthropathy after Latarjet procedure: a long-term study. Int Orthop, 2013, 37(6): 1093-1098.
18.	Minkus M, Wolke J, Fischer P, et al. Analysis of complication after open coracoid transfer as a revision surgery for failed soft tissue stabilization in recurrent anterior shoulder instability. Arch Orthop Trauma Surg, 2019, 139(10): 1435-1444.
19.	Willemot L, De Boey S, Van Tongel A, et al. Analysis of failures after the Bristow-Latarjet procedure for recurrent shoulder instability. Int Orthop, 2019, 43(8): 1899-1907.
20.	Prendergast PJ, Huiskes R. The biomechanics of Wolff’s law: recent advances. Ir J Med Sci, 1995, 164(2): 152-154.

1. Hurley ET, Montgomery C, Jamal MS, et al. Return to play after the Latarjet procedure for anterior shoulder instability: a systematic review. Am J Sports Med, 2019, 47(12): 3002-3008.
2. Hurley ET, Jamal MS, Ali ZS, et al. Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies at 10-year follow-up. J Shoulder Elbow Surg, 2019, 28(2): e33-e39.
3. Gilat R, Lavoie-Gagne O, Haunschild ED, et al. Outcomes of the Latarjet procedure with minimum 5- and 10-year follow-up: A systematic review. Shoulder Elbow, 2020, 12(5): 315-329.
4. Kee YM, Kim HJ, Kim JY, et al. Glenohumeral arthritis after Latarjet procedure: Progression and it’s clinical significance. J Orthop Sci, 2017, 22(5): 846-851.
5. Vezeridis PS, Ishmael CR, Jones KJ, et al. Glenohumeral dislocation arthropathy: etiology, diagnosis, and management. J Am Acad Orthop Surg, 2019, 27(7): 227-235.
6. Filho JG, Leite MC, Borges ACW, et al. Clinical and radiographic evaluation of patients operated by the Bristow-Latarjet technique with a minimum follow-up of 20 years. Rev Bras Ortop (Sao Paulo), 2020, 55(4): 455-462.
7. Allain J, Goutallier D, Glorion C. Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg (Am), 1998, 80(6): 841-852.
8. Balestro JC, Young A, Maccioni C, et al. Graft osteolysis and recurrent instability after the Latarjet procedure performed with bioabsorbable screw fixation. J Shoulder Elbow Surg, 2015, 24(5): 711-718.
9. Hovelius L, Sandström B, Saebö M. One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study Ⅱ-the evolution of dislocation arthropathy. J Shoulder Elbow Surg, 2006, 15(3): 279-289.
10. Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg, 2016, 25(1): 78-89.
11. Xu J, Liu H, Lu W, et al. Clinical outcomes and radiologic assessment of a modified suture button arthroscopic Latarjet procedure. BMC Musculoskelet Disord, 2019, 20(1): 173.
12. Xu J, Liu H, Lu W, et al. Modified arthroscopic Latarjet procedure: suture-button fixation achieves excellent remodeling at 3-year follow-up. Am J Sports Med, 2020, 48(1): 39-47.
13. Boileau P, Saliken D, Gendre P, et al. Arthroscopic Latarjet: suture-button fixation is a safe and reliable alternative to screw fixation. Arthroscopy, 2019, 35(4): 1050-1061.
14. Samilson RL, Prieto V. Dislocation arthropathy of the shoulder. J Bone Joint Surg (Am), 1983, 65(4): 456-460.
15. Lafosse L, Boyle S, Gutierrez-Aramberri M, et al. Arthroscopic latarjet procedure. Orthop Clin North Am, 2010, 41(3): 393-405.
16. Samim M, Small KM, Higgins LD. Coracoid graft union: a quantitative assessment by computed tomography in primary and revision Latarjet procedure. J Shoulder Elbow Surg, 2018, 27(8): 1475-1482.
17. Lädermann A, Lubbeke A, Stern R, et al. Risk factors for dislocation arthropathy after Latarjet procedure: a long-term study. Int Orthop, 2013, 37(6): 1093-1098.
18. Minkus M, Wolke J, Fischer P, et al. Analysis of complication after open coracoid transfer as a revision surgery for failed soft tissue stabilization in recurrent anterior shoulder instability. Arch Orthop Trauma Surg, 2019, 139(10): 1435-1444.
19. Willemot L, De Boey S, Van Tongel A, et al. Analysis of failures after the Bristow-Latarjet procedure for recurrent shoulder instability. Int Orthop, 2019, 43(8): 1899-1907.
20. Prendergast PJ, Huiskes R. The biomechanics of Wolff’s law: recent advances. Ir J Med Sci, 1995, 164(2): 152-154.

Chinese Journal of Reparative and Reconstructive Surgery

Radiographic study of effect of lateral placement of bone graft on shoulder joint degeneration after modified arthroscopic Latarjet surgery with elastic fixation

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