Association Between Preoperative Glenoid Bone Loss and Postoperative Outcomes After Coracoid Transfer Combined With Open Bankart Repair: Comparison of the Bristow and Latarjet Techniques

Takehito Hirose; Makoto Tanaka; Hidekazu Nakai; Hiroto Hanai; Yuki Kotani; Kosuke Kuratani; Kenji Hayashida

doi:10.1177/23259671231172219

Association Between Preoperative Glenoid Bone Loss and Postoperative Outcomes After Coracoid Transfer Combined With Open Bankart Repair: Comparison of the Bristow and Latarjet Techniques

Orthop J Sports Med. 2023 May 24;11(5):23259671231172219. doi: 10.1177/23259671231172219. eCollection 2023 May.

Authors

Takehito Hirose¹, Makoto Tanaka^{1

2}, Hidekazu Nakai¹, Hiroto Hanai³, Yuki Kotani³, Kosuke Kuratani⁴, Kenji Hayashida⁵

Affiliations

¹ Department of Orthopaedic Surgery, Daini Osaka Police Hospital, Osaka, Japan.
² Center for Sports Medicine, Daini Osaka Police Hospital, Osaka, Japan.
³ Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
⁴ Department of Orthopaedic Surgery, JCHO Osaka Hospital, Osaka, Japan.
⁵ Department of Orthopaedic Surgery, Osaka Central Hospital, Osaka, Japan.

Abstract

Background: Whether the extent of glenoid bone loss (GBL) affects clinical outcome after coracoid process transfer (CPT) is still unclear.

Purpose: To evaluate postoperative outcomes after CPT combined with open Bankart repair in young rugby players in terms of the extent of GBL and between the Bristow and Latarjet techniques.

Study design: Cohort study; Level of evidence, 3.

Methods: The authors investigated 101 shoulders in 91 competitive rugby players who underwent CPT combined with open Bankart repair by the Bristow (group B; 66 shoulders) or Latarjet (group L; 35 shoulders) procedure between 2007 and 2017. The extent of GBL was calculated from the en face view of the glenoid on preoperative 3-dimensional computed tomography scans and was used to categorize shoulders into 4 grades (grade 0, 0%; grade 1, >0% and ≤10%; grade 2, >10% and ≤20%; grade 3, >20%). At the minimum 2-year follow-up, the authors analyzed the relationship between GBL or GBL grade and postoperative outcome scores (American Shoulder and Elbow Surgeons score, Rowe score, Western Ontario Shoulder Instability Index, and patient satisfaction), return-to-play (RTP) times, graft failure (insufficient union or translocation), and recurrence.

Results: The mean GBL in all shoulders was 10.9% ± 9.2% and was not significantly different between the 2 groups. There were no significant correlations between GBL and any outcome measure in either group. The mean RTP time was significantly shorter in group L versus group B (4.8 ± 1.1 vs 5.8 ± 1.8 months, respectively; P = .002), but it was not associated with GBL. In group B, the rate of graft failure was not significantly higher in shoulders with grade 0 or 1 GBL versus grade 2 or 3 GBL (8 [25.0%] vs 4 [11.8%], respectively; P = .21). In group B, graft failure was confirmed in 12 shoulders (18.2%), compared with 1 shoulder (2.9%) in group L. Postoperative recurrence occurred in significantly fewer shoulders in group B than in group L (2 [3.0%] vs 5 [14.3%], respectively; P = .047).

Conclusion: The extent of GBL did not affect outcome scores after CPT, regardless of operative procedure.

Keywords: Bristow; Latarjet; clinical outcome; glenoid bone loss; instability; rugby; shoulder.