Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures

Background: Glenoid bone grafting procedures are often utilized to address glenoid bone loss in patients with recurrent shoulder instability. The purpose of this study was to determine if preoperative advanced imaging can accurately predict coracoid graft size and conversion of off-track to on-track...

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Main Authors: Stephanie A. Boden, MD, Brian M. Godshaw, MD, Jonathan D. Hughes, MD, Volker Musahl, MD, Albert Lin, MD, Bryson P. Lesniak, MD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:JSES International
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Online Access:http://www.sciencedirect.com/science/article/pii/S266663832400135X
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author Stephanie A. Boden, MD
Brian M. Godshaw, MD
Jonathan D. Hughes, MD
Volker Musahl, MD
Albert Lin, MD
Bryson P. Lesniak, MD
author_facet Stephanie A. Boden, MD
Brian M. Godshaw, MD
Jonathan D. Hughes, MD
Volker Musahl, MD
Albert Lin, MD
Bryson P. Lesniak, MD
author_sort Stephanie A. Boden, MD
collection DOAJ
description Background: Glenoid bone grafting procedures are often utilized to address glenoid bone loss in patients with recurrent shoulder instability. The purpose of this study was to determine if preoperative advanced imaging can accurately predict coracoid graft size and conversion of off-track to on-track Hill-Sachs lesions in patients undergoing Latarjet procedures. Methods: Patients who underwent Latarjet procedure for shoulder instability at a single institution from 2012 to 2020 with preoperative and postoperative advanced shoulder imaging (computerized tomography or magnetic resonance imaging scans) were retrospectively reviewed. Glenoid diameter, Hill-Sachs interval (HSI), and measurements of the coracoid length, depth, and height were measured on preoperative imaging. Glenoid track (GT), percent glenoid bone loss, predicted restoration of GT, and the difference between HSI and GT (ΔHSI-GT) were calculated. Results: Seventeen patients with a mean age of 25 ± 9 years met inclusion criteria. Average glenoid bone loss preoperatively was 24 ± 7% and average HSI was 27 ± 5mm. The Latarjet procedure reconstructed 116 ± 8% of the native glenoid, and 104 ± 8% of the predicted diameter. Of the 15 patients that had off-track lesions preoperatively, 11 were successfully converted to on-track lesions (73%). The 4 persistent off-track lesions had a significantly higher HSI (32 ± 2 mm vs. 26 ± 4 mm, P = .002). Preoperative measurements accurately predicted postoperative GT status in 94% of cases. At a mean follow-up of 2 years, there was no significant difference in recurrence rate or rate of revision stabilization procedures between patients with on-track versus persistent off-track humeral lesions. Conclusion: Preoperative advanced imaging measurements can accurately predict whether an off-track Hill-Sachs can be converted to on-track after Latarjet procedure, further enhancing shoulder stability.
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spelling doaj-art-c3f0bed0adc2435f83f4d27581f4611f2025-01-12T05:25:55ZengElsevierJSES International2666-63832025-01-019115Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet proceduresStephanie A. Boden, MD0Brian M. Godshaw, MD1Jonathan D. Hughes, MD2Volker Musahl, MD3Albert Lin, MD4Bryson P. Lesniak, MD5Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USAOchsner Sports Medicine Institute, New Orleans, LA, USA; University of Queensland School of Medicine, Brisbane, AustraliaDepartment of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USADepartment of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USADepartment of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USADepartment of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Corresponding author: Bryson P. Lesniak, MD, UPMC Department of Orthopaedic Surgery, 3200 South Water Street, Pittsburgh, PA 15203, USA.Background: Glenoid bone grafting procedures are often utilized to address glenoid bone loss in patients with recurrent shoulder instability. The purpose of this study was to determine if preoperative advanced imaging can accurately predict coracoid graft size and conversion of off-track to on-track Hill-Sachs lesions in patients undergoing Latarjet procedures. Methods: Patients who underwent Latarjet procedure for shoulder instability at a single institution from 2012 to 2020 with preoperative and postoperative advanced shoulder imaging (computerized tomography or magnetic resonance imaging scans) were retrospectively reviewed. Glenoid diameter, Hill-Sachs interval (HSI), and measurements of the coracoid length, depth, and height were measured on preoperative imaging. Glenoid track (GT), percent glenoid bone loss, predicted restoration of GT, and the difference between HSI and GT (ΔHSI-GT) were calculated. Results: Seventeen patients with a mean age of 25 ± 9 years met inclusion criteria. Average glenoid bone loss preoperatively was 24 ± 7% and average HSI was 27 ± 5mm. The Latarjet procedure reconstructed 116 ± 8% of the native glenoid, and 104 ± 8% of the predicted diameter. Of the 15 patients that had off-track lesions preoperatively, 11 were successfully converted to on-track lesions (73%). The 4 persistent off-track lesions had a significantly higher HSI (32 ± 2 mm vs. 26 ± 4 mm, P = .002). Preoperative measurements accurately predicted postoperative GT status in 94% of cases. At a mean follow-up of 2 years, there was no significant difference in recurrence rate or rate of revision stabilization procedures between patients with on-track versus persistent off-track humeral lesions. Conclusion: Preoperative advanced imaging measurements can accurately predict whether an off-track Hill-Sachs can be converted to on-track after Latarjet procedure, further enhancing shoulder stability.http://www.sciencedirect.com/science/article/pii/S266663832400135XShoulder instabilityLatarjetGlenoid bone lossOff-trackRecurrent shoulder instabilityGlenohumeral instability
spellingShingle Stephanie A. Boden, MD
Brian M. Godshaw, MD
Jonathan D. Hughes, MD
Volker Musahl, MD
Albert Lin, MD
Bryson P. Lesniak, MD
Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures
JSES International
Shoulder instability
Latarjet
Glenoid bone loss
Off-track
Recurrent shoulder instability
Glenohumeral instability
title Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures
title_full Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures
title_fullStr Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures
title_full_unstemmed Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures
title_short Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures
title_sort preoperative imaging predicts coracoid graft size and restoration of the glenoid track in latarjet procedures
topic Shoulder instability
Latarjet
Glenoid bone loss
Off-track
Recurrent shoulder instability
Glenohumeral instability
url http://www.sciencedirect.com/science/article/pii/S266663832400135X
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