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Elvire Servien - One of the best experts on this subject based on the ideXlab platform.
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A Biomechanical Evaluation of Bicortical Metal Screw Fixation Versus Absorbable Interference Screw Fixation After Coracoid Transfer for Anterior Shoulder Instability
Arthroscopy: The Journal of Arthroscopy and Related Surgery, 2011Co-Authors: Florent Weppe, Robert A. Magnussen, Sebastien Lustig, Guillaume Demey, Philippe Neyret, Elvire ServienAbstract:Purpose: The purpose was to evaluate the load to failure of 2 Coracoid fixation techniques after transfer of the Coracoid to the anterior glenoid neck. Methods: Ten cadavers (mean age, 87 years; range, 74 to 96 years) underwent the Bristow conjoined tendon tenodesis technique as described by Boileau et al. (bioabsorbable interference screw fixation of a Coracoid bone plug) in 1 shoulder and the Latarjet-Patte Coracoid transfer popularized by Walch (fixation with 2 screws through a larger piece of the Coracoid) in the opposite shoulder. The force on the conjoined tendon required to pull the Coracoid off of the anterior glenoid was recorded, along with the mode of construct failure. Results: The median ultimate failure load was 110 N (range, 35 to 170 N) in the interference screw group and 202 N (range, 95 to 300 N) in the bicortical screw group (P .002). The mode of failure of the interference screw technique was complete avulsion of the bone plug from the socket in 6 cases (60%) and fracture of the bone plug in 4 (40%). The mode of failure of the bone block technique was a vertical fracture through both screw holes in 7 cases (70%), a horizontal fracture through the distal screw hole in 2 (20%), and an intratendinous rupture of the conjoined tendon in 1 (10%). Conclusions: Fixation of a Coracoid bone block to the anterior glenoid neck with 2 bicortical metal screws is stronger than fixation of a Coracoid bone plug with an absorbable interference screw. Clinical Relevance: These data may influence surgeons' decisions regarding Coracoid fixation as well as postoperative rehabilitation after Coracoid transfer.
Peter Kloen - One of the best experts on this subject based on the ideXlab platform.
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The “Coracoid tunnel view”: a simulation study for finding the optimal screw trajectory in Coracoid base fracture fixation
Surgical and Radiologic Anatomy, 2019Co-Authors: C. H. Trikt, Johannes G. G. Dobbe, Johanna C E Donders, Geert J. Streekstra, Peter KloenAbstract:PurposeCoracoid fractures represent approximately 3–13% of all scapular fractures. Open reduction and internal fixation can be indicated for a Coracoid base fracture. This procedure is challenging due to the nature of visualization of the Coracoid with fluoroscopy. The aim of this study was to develop a fluoroscopic imaging protocol, which helps surgeons in finding the optimal insertion point and screw orientation for fixations of Coracoid base fractures, and to assess its feasibility in a simulation study.MethodsA novel imaging protocol was defined for screw fixation of Coracoid base fractures under fluoroscopic guidance. The method is based on finding the optimal view for screw insertion perpendicular to the viewing plane. In a fluoroscopy simulation environment, eight orthopaedic surgeons were invited to place a screw down the Coracoid stalk through the Coracoid base and into the neck of 14 cadaveric scapulae using anatomical landmarks. The surgeons placed screws before and after they received an e-learning of the optimal view. Results of the two sessions were compared and inter-rater reliability was calculated.ResultsScrew placement was correct in 33 out of 56 (58.9%) before, and increased to 50 out of 56 (89.3%) after the Coracoid tunnel view was explained to the surgeons, which was a significant improvement ( p
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The "Coracoid tunnel view": a simulation study for finding the optimal screw trajectory in Coracoid base fracture fixation.
Surgical and Radiologic Anatomy, 2019Co-Authors: C. H. Van Trikt, Johannes G. G. Dobbe, Johanna C E Donders, Geert J. Streekstra, Peter KloenAbstract:Purpose Coracoid fractures represent approximately 3–13% of all scapular fractures. Open reduction and internal fixation can be indicated for a Coracoid base fracture. This procedure is challenging due to the nature of visualization of the Coracoid with fluoroscopy. The aim of this study was to develop a fluoroscopic imaging protocol, which helps surgeons in finding the optimal insertion point and screw orientation for fixations of Coracoid base fractures, and to assess its feasibility in a simulation study.
Florent Weppe - One of the best experts on this subject based on the ideXlab platform.
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A Biomechanical Evaluation of Bicortical Metal Screw Fixation Versus Absorbable Interference Screw Fixation After Coracoid Transfer for Anterior Shoulder Instability
Arthroscopy: The Journal of Arthroscopy and Related Surgery, 2011Co-Authors: Florent Weppe, Robert A. Magnussen, Sebastien Lustig, Guillaume Demey, Philippe Neyret, Elvire ServienAbstract:Purpose: The purpose was to evaluate the load to failure of 2 Coracoid fixation techniques after transfer of the Coracoid to the anterior glenoid neck. Methods: Ten cadavers (mean age, 87 years; range, 74 to 96 years) underwent the Bristow conjoined tendon tenodesis technique as described by Boileau et al. (bioabsorbable interference screw fixation of a Coracoid bone plug) in 1 shoulder and the Latarjet-Patte Coracoid transfer popularized by Walch (fixation with 2 screws through a larger piece of the Coracoid) in the opposite shoulder. The force on the conjoined tendon required to pull the Coracoid off of the anterior glenoid was recorded, along with the mode of construct failure. Results: The median ultimate failure load was 110 N (range, 35 to 170 N) in the interference screw group and 202 N (range, 95 to 300 N) in the bicortical screw group (P .002). The mode of failure of the interference screw technique was complete avulsion of the bone plug from the socket in 6 cases (60%) and fracture of the bone plug in 4 (40%). The mode of failure of the bone block technique was a vertical fracture through both screw holes in 7 cases (70%), a horizontal fracture through the distal screw hole in 2 (20%), and an intratendinous rupture of the conjoined tendon in 1 (10%). Conclusions: Fixation of a Coracoid bone block to the anterior glenoid neck with 2 bicortical metal screws is stronger than fixation of a Coracoid bone plug with an absorbable interference screw. Clinical Relevance: These data may influence surgeons' decisions regarding Coracoid fixation as well as postoperative rehabilitation after Coracoid transfer.
M Mastantuono - One of the best experts on this subject based on the ideXlab platform.
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Coracoid bone graft osteolysis after latarjet procedure a comparison study between two screws standard technique vs mini plate fixation
International Journal of Shoulder Surgery, 2013Co-Authors: Giovanni Di Giacomo, Alberto Costantini, Nicola De Gasperis, Andrea De Vita, Bernard K H Lin, Marco Francone, Mario Rojas A Beccaglia, M MastantuonoAbstract:Aims: One of the reason for Latarjet procedure failure may be Coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the Coracoid process and the glenoid, using a mini‑plate fixation during the Latarjet procedure, could reduce the amount of Coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed‑up patients was conducted after modified Latarjet procedure using mini‑plate fixation technique to determine both the location and the amount of Coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini‑plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal Coracoid, whereas the deep part of the proximal Coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal Coracoid with our previous study (P < 0.01). Discussion: To our knowledge, there are no studies in literature that show the causes of Coracoid bone graft osteolysis after Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal Coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study.
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Coracoid graft osteolysis after the latarjet procedure for anteroinferior shoulder instability a computed tomography scan study of twenty six patients
Journal of Shoulder and Elbow Surgery, 2011Co-Authors: Giovanni Di Giacomo, Alberto Costantini, Nicola De Gasperis, Andrea De Vita, Bernard K H Lin, Marco Francone, Mario Rojas A Beccaglia, M MastantuonoAbstract:Background: The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability in certain patients. However, progression of the transferred Coracoid bone graft to osteolysis has been reported in the literature. We propose that the Coracoid bone graft osteolysis could be one of the causes of failure of the Latarjet procedure. Materials and methods: A computed tomography scan analysis was done of 26 patients prospectively followed-up after the Latarjet procedure to determine the location and the amount of the Coracoid graft osteolysis. Results: The most relevant osteolysis was represented by the superficial part of the proximal Coracoid, whereas the distal region of the Coracoid bone graft, especially in the deep portion, was the least involved in osteolysis and had the best bone healing. Discussion: To our knowledge, this is the first study to quantify and localize Coracoid osteolysis after Latarjet procedure for anteroinferior shoulder instability using CT scan analysis. Conclusion: Our study suggests that the bone-block effect from the Latarjet procedure may not be the principal effect in its treatment of anteroinferior shoulder instability in patients without significant bony defects. Level of evidence: Level IV, Prospective Case Series, Treatment Study. 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.
Julie Y Bishop - One of the best experts on this subject based on the ideXlab platform.
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prediction of Coracoid thickness using a glenoid width based model implications for bone reconstruction procedures in chronic anterior shoulder instability
Journal of Shoulder and Elbow Surgery, 2012Co-Authors: Karin L Ljungquist, Bryan R Butler, Michael J Griesser, Julie Y BishopAbstract:Background Chronic anterior shoulder instability with glenoid bone loss can be a very challenging clinical problem. Significant bone loss is commonly managed with the Latarjet procedure. However, in some cases with severe glenoid bone loss, iliac crest bone grafting is required to obtain a graft of adequate size. Iliac crest bone graft is associated with high rates of donor-site complications. Whereas glenoid dimensions can be determined by use of 3-dimensional computed tomography reconstructions, the thickness of the Coracoid cannot be easily measured. This study aims to define a ratio between glenoid width and Coracoid thickness that can be used in preoperative planning to determine whether Coracoid transfer will yield adequate bone graft to restore glenoid contour or whether iliac crest bone graft must be taken. Methods We studied 100 paired cadaveric scapulae (50 male and 50 female scapulae). The bony dimensions of the Coracoid and glenoid were measured for each specimen. Results Coracoid and glenoid dimensions are provided. The mean thickness of the male Coracoid was 35.4% of the width of the glenoid. The mean female Coracoid thickness was 34.4% of the glenoid width. Discussion A new biomorphologic model is presented to predict Coracoid thickness and the ability of the Latarjet procedure to restore stability to a given bone-deficient glenoid. This model may aid the shoulder surgeon in preoperative planning and help promote successful outcomes in glenoid reconstruction surgery by determining whether a Latarjet procedure or iliac crest bone graft is the most appropriate procedure given the predicted amount of Coracoid bone graft available.