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Arthroscopic double-button Latarjet: two-thirds of bone block healed at 90 days

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Abstract

Purpose

The aim of this study was to evaluate the union rate and risk factors for delayed union in the early postoperative period after an arthroscopic Latarjet with double-button fixation.

Method

In a retrospective study, postoperative CT scans at 3 months were analysed following an arthroscopic Latarjet with double-button fixation used to treat anterior shoulder instability. Healing of the bone block, its position in the sagittal and coronal planes, and the contact area graft/scapula were analysed.

Results

Ninety-eight CT scans (98 patients) were included. The rate of healing at 3 months was 63/98 (64%) and four grafts clearly migrated. The position was perfectly flush to the glenoid rim in 67% and under the equator in 96%. The mean contact graft/scapula area was 135 mm 2 (4–420). In multivariate analysis, the risk of non-union at 3 months was associated with tobacco consumption (p = 0.001, aOR = 12.17 95% CI [2.62–56.49]), absence of preoperative glenoid bone defect (p = 0.003, aOR = 8.06 95% CI [2.06–31.56]), and a contact area graft/scapula less than 120 mm 2 (p = 0.010, aOR = 5.25 95% CI [1.50–18.40]). Among 31 non-united grafts, 93% definitively healed on CT scan at 1 year, leaving an overall rate of 93% of united grafts at last follow-up.

Conclusions

The rate of union at 3 months after an arthroscopic Latarjet with double-button fixation was 64%, reaching 93% at 1 year. This procedure should be carefully indicated in case of tobacco use or instability without glenoid bone defect, especially when the shoulder is exposed to high-energy trauma in the early phase after surgery.

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Author information

Correspondence to Nicolas Bonnevialle.

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Conflict of interest

Yoann Dalmas, Pierre Laumonerie, Marie Faruch and Mathieu Girard have no conflict of interest. Charles Edouard Thélu and Nicolas Bonnevialle are consultant for Smith & Nephew.

Ethical approval

Approval was obtained from the Ethics Committee of University Hospital of Toulouse, France to conduct this study (IRB 01-526).

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Dalmas, Y., Thélu, C.E., Laumonerie, P. et al. Arthroscopic double-button Latarjet: two-thirds of bone block healed at 90 days. Knee Surg Sports Traumatol Arthrosc (2020) doi:10.1007/s00167-019-05830-7

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Keywords

  • Latarjet
  • Arthroscopic
  • Non-union
  • Shoulder instability
  • Bone block
  • Double button
  • CT scan
  • Risk factors
  • Tobacco